In this section, we take a look at gastrointestinal
disease of the stomach and the duodenum.
We begin by looking at GI bleeding. Forms of GI
bleeding and what it means to you clinically.
If there’s hematemesis, well, you’re thinking about
vomiting up blood and usually it indicates bleeding
proximal to the ligament of Treitz. The ligament of
Treitz is dividing your GI system into a proximal
and a distal portion. And it is a line between the
duodenum and the jejunum. So technically speaking,
that in which you find bleeding that's taking place
proximal to the Treitz may result to hematemesis.
Melena. Melena to you should mean that there is
enough time of the blood to then set into the feces.
And so therefore by the time the feces has then
evacuated, the stools then appears to be black
and tarry. Therefore, for the most part though,
melena should indicate upper GI bleeding
but technically speaking, it can occur
anywhere from the GI tract. Anywhere.
However, if it is hematochezia then this would be
bright red. And this to you should indicate that the
bleeding is quite distal more so in the colon.
Give yourself an example such as
Diverticulosis, where you find significant bright red blood in the stools
and can even have frank bleeding from the rectum.
Another common cause of this is left-sided colon cancer.
Now his clinical finding usually indicates a lower GI bleed,
but in some situations such as a perforated ulcer,
the rapid nature of the bleeding can shorten GI transit time resulting in a simmilar presentation.