TY - CHAP M1 - Book, Section TI - Gastrointestinal Bleeding A1 - Reyes, Sonia M. A1 - Bronner, Jonathan A2 - Stone, C. Keith A2 - Humphries, Roger L. Y1 - 2017 N1 - T2 - CURRENT Diagnosis & Treatment: Emergency Medicine, 8e AB - For the majority of patients presenting with gastrointestinal (GI) bleeding, hematemesis, hematochezia, or melena will be the chief complaint. Occasionally, patients may present with only dizziness, weakness, lethargy, angina, or syncope. Upper GI bleeding often presents with vomiting fresh blood (hematemesis), vomiting of dark-colored, granular material (“coffee-ground” emesis), and/or black tarry stools (melena). The passing of blood from rectum (hematochezia) usually indicates bleeding from the lower GI tract. The severity of blood loss must be assessed quickly so that lifesaving therapeutic interventions can be instituted. Factors that increase morbidity and mortality include hemodynamic instability, ongoing symptoms suggesting active bleeding, low initial hemoglobin, age over 65, abnormalities in renal, hepatic, and cardiac function, and other comorbidities. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accessemergencymedicine.mhmedical.com/content.aspx?aid=1176286443 ER -