Melena causes: Difference between revisions

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Revision as of 07:27, 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, pneumatosis cystoides intestinalis, 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, 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	Adenocarcinoma, anal cancer, blue rubber bleb nevus syndrome, carcinoid, cecal carcinoma, choriocarcinoma, colorectal cancer, esophageal cancer, familial adenomatous polyposis, Gardner syndrome, gastric cancer, hemangiomas, kaposi sarcoma, lipoma, lymphoma, malignancy, melanoma, mesenchymal neoplasm, metastatic tumor, Peutz-Jeghers syndrome, small bowel cancer, small bowel lymphoma, small bowel tumors, stomach cancer, systemic mastocytosis, tumors
Ophthalmologic	Coats plus syndrome
Overdose/Toxicity	Drug overdose
Psychiatric	No underlying causes
Pulmonary	No underlying causes
Renal/Electrolyte	Cholesterol embolism, chronic renal failure, craniomandibular dermatodysostosis, Henoch-Schoenlein purpura
Rheumatology/Immunology/Allergy	Crohn's disease, dermatomyositis, food allergy, food protein-induced enterocolitis syndrome (FPIES), Henoch-Schoenlein purpura, microscopic polyangiitis, polyarteritis nodosa, systemic mastocytosis, vasculitis, Wiskott-Aldrich syndrome
Sexual	No underlying causes
Trauma	Trauma
Urologic	No underlying causes
Miscellaneous	Foreign body, swallowed maternal blood

Causes in Alphabetical Order

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]], [[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]], [[pneumatosis intestinalis|pneumatosis cystoides intestinalis]], [[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]], [[enteric duplication cysts|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]], [[pneumatosis intestinalis|pneumatosis cystoides intestinalis]], [[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"