Melena causes: Difference between revisions

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Revision as of 06:02, 23 July 2014

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ogheneochuko Ajari, MB.BS, MS [2]

Overview

The most common cause of melena is peptic ulcer disease. Any other cause of bleeding from the upper gastro-intestinal tract, or even the ascending colon, can also cause melena. Melena may also be a sign of drug overdose if a patient is taking anti-coagulants, such as warfarin. A less serious, self-limiting case of melena can occur in newborns two to three days after delivery, due to swallowed maternal blood.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Causes by Organ System

Cardiovascular	Cholesterol embolism, mesenteric vascular occlusion, vasculitis
Chemical/Poisoning	Arsenic trioxide, arsenicals, caustic ingestion, ethylene glycol, mercury
Dental	No underlying causes
Dermatologic	Craniomandibular dermatodysostosis, Degos disease, dermatomyositis, hereditary haemorrhagic telangiectasia, Osler-Weber-Rendu syndrome, vasculitis
Drug Side Effect	Alendronate, alosetron, anticoagulants, aspirin, bevacizumab, clopidogrel, colchicine, dicoumarol, indomethacin, iron compounds, melarsoprol, NSAIDS, phenprocoumon, phenylbutazone, potassium chloride, quinidine, tetracycline, warfarin, zinc, ziv-aflibercept
Ear Nose Throat	Hereditary haemorrhagic telangiectasia, Osler-Weber-Rendu syndrome
Endocrine	Carcinoid
Environmental	No underlying causes
Gastroenterologic	Alcoholic cirrhosis, alcoholic fatty liver, anal fissure, angiodysplasia, aortoenteric fistula, Banti's syndrome, biliary atresia, bowel ischemia, bowel obstruction, bowel strangulation, Budd-Chiari syndrome, chronic portal vein thrombosis, Coats plus syndrome, colitis cystica profunda, colitis, colonic diverticulosis, colonic tubular adenomata, colonic villous adenomata, colonoscopy, colorectal cancer, Crohn's disease, Degos disease, Dieulafoy's ulcer, duodenal polypectomy, duodenal ulcer, duodenal webs, duplication cysts, esophageal cancer, esophageal cyst, esophageal varices, familial adenomatous polyposis, Gardner syndrome, gastric antral vascular ectasia, Gastric cancer, gastric polyps, gastric ulcer, gastric volvulus, gastric webs, gastritis, gastroduodenal ulcers, gastrointestinal duplications, hemorrhoids, hemobilia, hepatic arterioportal fistula, intussusception, liver cirrhosis, Mallory-Weiss syndrome, Mallory-Weiss tear, Meckel's diverticulum, Ménétrier's disease, mesenteric vascular occlusion, peptic ulcer, Peutz-Jeghers syndrome, portal hypertension, portal hypertensive gastropathy, proctitis, ruptured esophageal varices, solitary rectal ulcer syndrome, stomach cancer, stress gastritis, stress ulcer, superior mesenteric artery occlusion, ulcerative colitis, watermelon stomach, Zollinger-Ellison syndrome
Genetic	Banti's syndrome, carbamoylphosphate synthetase deficiency, coats plus syndrome, Crohn's disease, Ehlers-Danlos syndrome, familial adenomatous polyposis, Gardner syndrome, hepatorenal tyrosinemia, Kasabach-Merritt syndrome, neurofibromatosis type I, Peutz-Jeghers syndrome, pseudoxanthoma elasticum, Wiskott-Aldrich syndrome
Hematologic	Blood clotting disorders, carcinoid, coagulopathy, essential thrombocytosis, hemophilia, haemorrhagic disease of the newborn, hemorrhagic thrombocythemia, Henoch-Schoenlein purpura, iron deficiency anemia, Kasabach-Merritt syndrome, systemic mastocytosis, thrombocytopenia, Wiskott-Aldrich syndrome
Iatrogenic	Parenteral nutrition-induced liver disease, post-surgical anastomosis, radiation-induced telangiectasia
Infectious Disease	Acanthocephaliasis, ancylostoma duodenale, angiostrongyliasis, anthrax, bacillary dysentery, balantidiasis, candida albicans, cytomegalovirus, ebola virus, entamoeba histolytica, giardiasis, helicobacter pylori, herpes simplex virus, Katayama fever , necator americanus (hookworm), parasites, pneumatosis cystoides intestinalis, schistosoma mansoni, strongyloidiasis, trichuriasis, typhoid fever, yellow fever
Musculoskeletal/Orthopedic	Craniomandibular dermatodysostosis, Ehlers-Danlos syndrome, pelvic fracture
Neurologic	Degos disease, hereditary haemorrhagic telangiectasia, Labrune syndrome, neurofibromatosis type I, Osler-Weber-Rendu syndrome
Nutritional/Metabolic	Carbamoylphosphate synthetase deficiency, hepatorenal tyrosinemia, milk protein intolerance
Obstetric/Gynecologic	Choriocarcinoma, endometriosis, leiomyoma
Oncologic	No underlying causes
Ophthalmologic	No underlying causes
Overdose/Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	No underlying causes
Renal/Electrolyte	No underlying causes
Rheumatology/Immunology/Allergy	No underlying causes
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Miscellaneous	No underlying causes

Causes in Alphabetical Order

Acanthocephaliasis
Adenocarcinoma
Alcoholic cirrhosis
Alcoholic fatty liver
Alendronate
Alosetron
Anal cancer
Anal fissure
Ancylostoma duodenale
Angiodysplasia
Angiostrongyliasis
Anthrax
Anticoagulants
Aortoenteric fistula
Arsenic trioxide
Arsenicals
Aspirin
Bacillary dysentery
Balantidiasis
Banti's syndrome
Bevacizumab
Biliary atresia
Blood clotting disorders
Blue rubber bleb nevus syndrome
Bowel ischemia
Bowel obstruction
Bowel strangulation
Budd-Chiari syndrome
Candida albicans
Carbamoylphosphate synthetase deficiency
Carcinoid
Caustic ingestion
Cecal carcinoma
Cholesterol embolism
Choriocarcinoma
Chronic portal vein thrombosis
Clopidogrel
Coagulopathy
Coats plus syndrome
Colchicine
Colitis
Colitis cystica profunda
Colonic diverticulosis
Colonic tubular adenomata
Colonic villous adenomata
Colonoscopy
Colorectal cancer
Craniomandibular dermatodysostosis

References

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@@ Line 55: / Line 55: @@
 |-bgcolor="LightSteelBlue"
 | '''Gastroenterologic'''
-|bgcolor="Beige"| [[Alcoholic cirrhosis]], [[alcoholic fatty liver]], [[anal fissure]], [[angiodysplasia]], [[aortoenteric fistula]], [[Banti's syndrome]], [[biliary atresia]], [[bowel ischemia]], [[bowel obstruction]], [[bowel strangulation]], [[Budd-Chiari syndrome]], [[portal vein thrombosis|chronic portal vein thrombosis]], Coats plus syndrome, [[colitis cystica profunda]], [[colitis]], [[colonic diverticulosis]], [[colonic tubular adenomata]], [[colonic villous adenomata]], [[colonoscopy]], [[colorectal cancer]], [[Crohn's disease]], [[Degos disease]], [[Dieulafoy's lesion|Dieulafoy's ulcer]], [[polypectomy|duodenal polypectomy]], [[duodenal ulcer]], [[duodenal webs]], [[mesenteric cyst|duplication cysts]], [[esophageal cancer]], [[esophageal cyst]], [[esophageal varices]], [[familial adenomatous polyposis]], [[Gardner syndrome]], [[gastric antral vascular ectasia]], [[Gastric cancer]], [[gastric polyps]], [[gastric ulcer]], [[gastric volvulus]], [[gastric webs]], [[gastritis]], [[gastroduodenal ulcers]], [[gastrointestinal duplications]], [[hemorrhoids]], [[hemobilia]], [[hepatic arterioportal fistula]], [[intussusception]], [[liver cirrhosis]], [[Mallory-Weiss syndrome]], [[Mallory-Weiss tear]], [[Meckel's diverticulum]], [[Ménétrier's disease]], [[mesenteric ischemia|mesenteric vascular occlusion]], [[peptic ulcer]], [[Peutz-Jeghers syndrome]], [[portal hypertension]], [[portal hypertensive gastropathy]], [[proctitis]], [[esophageal varices|ruptured esophageal varices]], [[solitary rectal ulcer syndrome]], [[stomach cancer]], [[gastritis|stress gastritis]], [[peptic ulcer|stress ulcer]], [[superior mesenteric artery|superior mesenteric artery occlusion]], [[ulcerative colitis]], [[watermelon stomach]], [[Zollinger-Ellison syndrome]]
+|bgcolor="Beige"| [[Alcoholic cirrhosis]], [[alcoholic fatty liver]], [[anal fissure]], [[angiodysplasia]], [[aortoenteric fistula]], [[Banti's syndrome]], [[biliary atresia]], [[bowel ischemia]], [[bowel obstruction]], [[bowel strangulation]], [[Budd-Chiari syndrome]], [[portal vein thrombosis|chronic portal vein thrombosis]], Coats plus syndrome, [[colitis cystica profunda]], [[colitis]], [[diverticulosis|colonic diverticulosis]], [[colonic tubular adenomata]], [[colonic villous adenomata]], [[colonoscopy]], [[colorectal cancer]], [[Crohn's disease]], [[Degos disease]], [[Dieulafoy's lesion|Dieulafoy's ulcer]], [[polypectomy|duodenal polypectomy]], [[duodenal ulcer]], [[duodenal webs]], [[mesenteric cyst|duplication cysts]], [[esophageal cancer]], [[esophageal cyst]], [[esophageal varices]], [[familial adenomatous polyposis]], [[Gardner syndrome]], [[gastric antral vascular ectasia]], [[Gastric cancer]], [[gastric polyps]], [[gastric ulcer]], [[gastric volvulus]], [[gastric webs]], [[gastritis]], [[gastroduodenal ulcers]], [[gastrointestinal duplications]], [[hemorrhoids]], [[hemobilia]], [[hepatic arterioportal fistula]], [[intussusception]], [[liver cirrhosis]], [[Mallory-Weiss syndrome]], [[Mallory-Weiss tear]], [[Meckel's diverticulum]], [[Ménétrier's disease]], [[mesenteric ischemia|mesenteric vascular occlusion]], [[peptic ulcer]], [[Peutz-Jeghers syndrome]], [[portal hypertension]], [[portal hypertensive gastropathy]], [[proctitis]], [[esophageal varices|ruptured esophageal varices]], [[solitary rectal ulcer syndrome]], [[stomach cancer]], [[gastritis|stress gastritis]], [[peptic ulcer|stress ulcer]], [[superior mesenteric artery|superior mesenteric artery occlusion]], [[ulcerative colitis]], [[watermelon stomach]], [[Zollinger-Ellison syndrome]]
 |-
 |-bgcolor="LightSteelBlue"
 | '''Genetic'''
-|bgcolor="Beige"| No underlying causes
+|bgcolor="Beige"| [[Banti's syndrome]], [[carbamoylphosphate synthetase deficiency]], coats plus syndrome, [[Crohn's disease]], [[Ehlers-Danlos syndrome]], [[familial adenomatous polyposis]], [[Gardner syndrome]], [[hepatorenal tyrosinemia]], [[Kasabach-Merritt syndrome]], [[neurofibromatosis type I]], [[Peutz-Jeghers syndrome]], [[pseudoxanthoma elasticum]], [[Wiskott-Aldrich syndrome]]
 |-
 |-bgcolor="LightSteelBlue"
 | '''Hematologic'''
-|bgcolor="Beige"| No underlying causes
+|bgcolor="Beige"| [[coagulopathy|Blood clotting disorders]], [[carcinoid]], [[coagulopathy]], [[essential thrombocytosis]], [[hemophilia]], [[haemorrhagic disease of the newborn]], [[essential thrombocytosis|hemorrhagic thrombocythemia]], [[Henoch-Schoenlein purpura]], [[iron deficiency anemia]], [[Kasabach-Merritt syndrome]], [[systemic mastocytosis]], [[thrombocytopenia]], [[Wiskott-Aldrich syndrome]]
 |-
 |-bgcolor="LightSteelBlue"
 | '''Iatrogenic'''
-|bgcolor="Beige"| No underlying causes
+|bgcolor="Beige"| [[total parenteral nutrition|Parenteral nutrition-induced liver disease]], [[anastomosis|post-surgical anastomosis]], [[telangiectasia|radiation-induced telangiectasia]]
 |-
 |-bgcolor="LightSteelBlue"
 | '''Infectious Disease'''
-|bgcolor="Beige"| No underlying causes
+|bgcolor="Beige"| [[Acanthocephaliasis]], [[ancylostoma duodenale]], [[angiostrongyliasis]], [[anthrax]], [[bacillary dysentery]], [[balantidiasis]], [[candida albicans]], [[cytomegalovirus]], [[ebola virus]], [[entamoeba histolytica]], [[giardiasis]], [[helicobacter pylori]], [[herpes simplex virus]], [[Katayama fever ]], [[necator americanus|necator americanus (hookworm)]], [[parasites]], [[pneumatosis cystoides intestinalis]], [[schistosoma mansoni]], [[strongyloidiasis]], [[trichuriasis]], [[typhoid fever]], [[yellow fever]]
 |-
 |-bgcolor="LightSteelBlue"
 | '''Musculoskeletal/Orthopedic'''
-|bgcolor="Beige"| No underlying causes
+|bgcolor="Beige"| Craniomandibular dermatodysostosis, [[Ehlers-Danlos syndrome]], [[pelvic fracture]]
 |-
 |-bgcolor="LightSteelBlue"
 | '''Neurologic'''
-|bgcolor="Beige"| No underlying causes
+|bgcolor="Beige"| [[Degos disease]], [[hereditary haemorrhagic telangiectasia]], Labrune syndrome, [[neurofibromatosis type I]], [[Osler-Weber-Rendu syndrome]]
 |-
 |-bgcolor="LightSteelBlue"
 | '''Nutritional/Metabolic'''
-|bgcolor="Beige"| No underlying causes
+|bgcolor="Beige"| [[Carbamoylphosphate synthetase deficiency]], [[hepatorenal tyrosinemia]], [[milk protein intolerance]]
 |-
 |-bgcolor="LightSteelBlue"
 | '''Obstetric/Gynecologic'''
-|bgcolor="Beige"| No underlying causes
+|bgcolor="Beige"| [[Choriocarcinoma]], [[endometriosis]], [[leiomyoma]]
 |-
 |-bgcolor="LightSteelBlue"