Gastrointestinal Bleeding – Part 1
Patients are usually quite alarmed when they pass blood from the rectum or in their vomit, although for surgeons, this is a fairly common complaint in patients. Blood in the gastrointestinal tract is always abnormal and surgeons classify it as upper gastrointestinal bleeding or lower gastrointestinal bleeding.
Upper GI bleeding is defined as bleeding that occurs from the mouth, stomach, bile system, or duodenum. It can present as blood in the vomit, bright red blood per rectum (hematochezia), or black or reddish/brownish blood per rectum (melena). It is a misconception that if the blood per rectum is bright red, it must be from the lower GI tract. If patients have a brisk upper GI bleed, approximately 10% will have bright red blood per rectum. Lower GI bleeding occurs from a source distal to the ligament of Treitz (the boundary of the start of the jejunum). It can present either as dark red blood or bright red blood.
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