- Melena suggests a proximal GI bleeding source in which there is time for enzymatic breakdown to transform blood to melena. How much blood in the stomach does it take to cause melena?
- What is a Morel-Lavallee lesion
- What is an Essex–Lopresti injury?
- What is the number one cause of fatal ingestions in children under 5 years of age (in the US)?
- What topical medication has been recently reported as a cause of methemoglobinemia in infants and children?
The first step in managing an acute upper GI bleed is to stabilize the patient with airway and volume restoration. An acidic environment promotes platelet disaggregation, fibrinolysis, and impairs clot formation, hence the utility of using PPI therapy. There is no proven mortality benefit to using PPI therapy, although it is still commonly used in practice. Early upper endoscopy within 24 hours of presentation is recommended in most patients because it confirms the diagnosis and allows for targeted treatment.