Summary

Upper gastrointestinal bleeding (UGIB) refers to GI blood loss whose origin is proximal to the ligament of Treitz at the duodenojejunal junction. Acute UGIB can manifest in a variety of manners, including haematemesis, coffee-ground emesis, the return of bright red blood through a nasogastric tube, and melaena with or without haemodynamic compromise. Haematochezia (bright red blood per rectum) may occur in patients with an extremely brisk UGIB. [1] [2] Causes are multiple, but in westernised countries they are usually secondary to either varices or PUD.

UGIB results in more than 300,000 hospital admissions annually in the US, with a mortality of 7% to 10%. [3] The annual incidence in the United Kingdom is 50 to 150 per 100,000, with the highest incidence in socio-economically deprived areas. [4] Ordinarily, mortality is secondary to hypovolaemic shock. Rapid evaluation, haemodynamic resuscitation, and appropriate pharmacological and endoscopic interventions are the cornerstones of therapy.