Upper Gastrointestinal Bleeding

Upper gastrointestinal bleeding (UGIB) is a common problem with an annual incidence of approximately 80 to 150 per 100,000 population, with an estimated mortality rate of 2% to 10%. UGIB is classified as any blood loss from a gastrointestinal source in the esophagus, stomach, or duodenum; historically defined as above the ligament of Treitz, a fibromuscular band extending from the upper surface of the duodenojejunal junction. UGIB can manifest as hematemesis, be it bright red or coffee-ground emesis, hematochezia, or melena. Patients may also present with systemic symptoms secondary to blood loss, such as orthostasis, syncope, fatigue, and weakness. Prior data from the United States show that UGIB accounts for nearly 40% of hospital admissions for gastrointestinal bleeding, with an estimated annual cost of over 2 billion dollars.