The source is generally the upper gastrointestinal tract, typically above the suspensory muscle of duodenum.
It may be caused by ulcers, tumors of the stomach or esophagus, varices, prolonged and vigorous retching, gastroenteritis, ingested blood (from bleeding in the mouth, nose, or throat), or certain drugs.
[citation needed] Hematemesis is treated as a medical emergency, with treatments based on the amount of blood loss.
[2] Coffee ground vomiting is similar to hematemesis, but is distinct in not involving bright red blood.
Severe loss makes it impossible for the heart to pump a sufficient amount of blood to the body.
Surgical opinion is usually sought in case the source of bleeding cannot be identified endoscopically, and laparotomy is necessary.
Bleeding that brings the patient to the physician is a potential emergency and must be considered as such until its seriousness can be evaluated.
The goals in managing a major acute gastrointestinal hemorrhage are to treat hypovolemia by restoring the blood volume to normal, to make a diagnosis of the bleeding site and its underlying cause, and to treat the cause of the bleeding as definitively as possible.
The history should be directed toward (1) confirming the presence of bleeding; (2) estimating its amount and rapidity; (3) identifying the source and potential specific causes; and (4) eliciting the presence of serious associated diseases that might adversely affect the outcome.