Medium urgency
CommonModerately severe
It is bleeding in the upper part of the digestive tract, which runs from the oesophagus to the first portion of the small intestine (duodenum).
The most common causes are gastric or duodenal ulcers.
It manifests with vomiting of blood and/or tar-coloured, pasty stools. It may be accompanied by skin pallor, tachycardia, hypotension and a significant feeling of tiredness.
It is diagnosed by a complete medical history, physical examination, blood tests and digestive endoscopy.
The first objective of hospital treatment is to stabilise blood pressure by administering blood and/or saline. Any alteration of the blood coagulation components must be corrected. If delayed, digestive endoscopy should be performed to directly treat the site of bleeding.
- John R Saltzman. Approach to acute upper gastrointestinal bleeding in adults. UpToDate Nov 12, 2015.
- Don C Rockey. Causes of upper gastrointestinal bleeding in adults. UpToDate Jan 12, 2016.
- Enestvedt BK, Gralnek IM, Mattek N, et al. An evaluation of endoscopic indications and findings related to nonvariceal upper-GI hemorrhage in a large multicenter consortium. Gastrointest Endosc 2008; 67:422.
- Barkun AN, Bardou M, Kuipers EJ, et al. International consensus recommendations on the management of patients with nonvariceal upper gastrointestinal bleeding. Ann Intern Med 2010; 152:101.
- Gralnek IM, Dumonceau JM, Kuipers EJ, et al. Diagnosis and management of nonvariceal upper gastrointestinal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2015; 47:a1.
- Loren Laine. Hemorragia de tubo digestivo. Harrison. Principios de Medicina Interna. Volumen 1. 19º Edición. 276:279.
- J M Piqué, J Terés. Hemorragia Digestiva Alta. Farreras Rozman. Medicina Interna. Volumen 1. 12º edición. 231:236.
Dr. Oscar Garcia-Esquirol
Copyright© TeckelMedical 2026
