Melena

doi:10.1017/9781009500760.001

Chapter 1 - Melena

Published online by Cambridge University Press: 24 April 2026

Grace Hickam and

Scott Huang

Edited by

Angela Bray Lindsay and

Monica Kathleen Wattana

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Angela Bray Lindsay: Affiliation:
Virginia Commonwealth University
Monica Kathleen Wattana: Affiliation:
University of Texas, MD Anderson Cancer Center

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Summary

1. Gastrointestinal hemorrhage is common in cancer patients and special consideration should be given to type of cancer, chemotherapy use, and other comorbidities.

2. Early distinction between upper and lower GI bleed source should be made with consideration based on symptoms, lab work, and imaging.

3. Initial treatment includes assessment of ABCs, early fluid resuscitation, blood transfusions, and reversal of any coagulopathy or anticoagulation.

4. High dose PPI treatment in upper GI bleeds should be given in conjunction with initial treatments in anticipation of endoscopy

5. Endoscopy and/or colonoscopy should be performed early in the clinical course. IR embolization or palliative radiation can be considered if endoscopy fails to result in hemostasis or if rebleeding occurs.

Keywords

Gastrointestinal (GI) Hemorrhage Upper Gastrointestinal Bleed Lower Gastrointestinal Bleed Endoscopy Colonoscopy Gastric malignancy Hematochezia Hematemesis

Information

Type: Chapter
Information: Oncologic Emergency Medicine
Clinical Cases Illustrating Key Concepts
, pp. 1 - 4
DOI: https://doi.org/10.1017/9781009500760.001 [Opens in a new window]
Publisher: Cambridge University Press
Print publication year: 2026

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