Haematemesis and melaena – a review of upper gastrointestinal bleeding

Abstract

Upper gastrointestinal bleeding (UGIB) carries a 2–10% mortality rate. The most common aetiology is peptic ulcer disease (25%). Other causes include varices, malignancies and vascular malformations. Rapid recognition of UGIB and prompt resuscitation are essential. Pre-endoscopic scoring tools enable the identification of low-risk patients. Restrictive transfusion strategies carry mortality benefits. Endoscopic treatment can include adrenaline therapy, thermal cautery, mechanical clips, band ligation or application of haemostatic compounds. Post-endoscopic care is directed towards the underlying aetiology.