Hematemesis:vomitting of blood of altered blood(coffee grounds) indicates bleeding proximal to ligament of Treitz
Melena:Tarry stool. Altered (black) blood per rectum (>60ml)
Hematochezia: Bright red or maroon rectal ,bleeding implies bleeding beyond Lig.treitz.

Differentiating Upper from Low GI Bleeding
Hematochezia usually represents a lower GI source bleeding
Upper GI lesion may bleed so briskly that blood doesn`t remain in bowl long enough to become melena
Bleeding lesion distal to treitz Lig.may be either Melena or hematochezia, but never manifests hematemesis

Common cause of upper GI bleeding
Peptic ulcer
Gastropathy (alcohol, aspirin, NSAIDs, stress)
Oesophageal varices
Gastric cancer

Less common cause of upper GI bleeding
Esophageal or intestinal neoplam
Esophagitis; Malloy-weiss tear,
Hemoptysis: Swallowed blood
Anticoagulant fibrinoloytic therapy:
Telangiectases; aneurysm ;vasculitis;Dieulafoy ulcer; AV malformation
Connective tissue disease;
Hemabilia(biliary origin;Crohn`s disease;amyloidosis , hematological diseases

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