Upper gastrointestinal bleeding is hemorrhage arising from any site between the mouth and the ligament of Treitz. It may be microscopic, silently lowering blood counts, or massive, producing dramatic visible blood loss that endangers life within minutes. Recognizing the spectrum of presentations allows rapid triage, adequate resuscitation, and targeted endoscopic therapy. Key visual clues• Hematemesis: vomiting red liquid or clots signals brisk arterial bleeding; when gastric acid acts for minutes the material turns “coffee-ground.”• Melena: black, tarry, foul-smelling stool that sticks to porcelain; at least 50 mL of upper-tract blood is required to produce this change, but melena can continue... Learn more

Upper gastrointestinal bleeding refers to hemorrhage originating from any site between the mouth and the ligament of Treitz. It ranges from trivial ooze noticed only on laboratory testing to catastrophic, life-threatening exsanguination. Rapid recognition of its varied presentations allows timely resuscitation and definitive hemostasis. Key visual clues• Hematemesis: vomiting fresh red blood or clots indicates active, usually arterial, bleeding; when gastric acid mixes with blood for minutes the appearance becomes “coffee-ground.”• Melena: black, tarry, foul-smelling stool that sticks to the toilet bowl; at least 50 mL of blood in the upper tract is needed to produce this change.• Nasogastric aspiration:... Learn more