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| *[[Choriocarcinoma]] | | *[[Choriocarcinoma]] |
| *[[portal vein thrombosis|Chronic portal vein thrombosis]] | | *[[portal vein thrombosis|Chronic portal vein thrombosis]] |
| | *[[Chronic renal failure]] |
| *[[Clopidogrel]] | | *[[Clopidogrel]] |
| *[[Coagulopathy]] | | *[[Coagulopathy]] |
| *Coats plus syndrome | | *Coats plus syndrome |
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| | {{col-break|width=33%}} |
| | {{col-break|width=33%}} |
| *[[Colchicine]] | | *[[Colchicine]] |
| *[[Colitis]] | | *[[Colitis]] |
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| *[[Colorectal cancer]] | | *[[Colorectal cancer]] |
| *Craniomandibular dermatodysostosis | | *Craniomandibular dermatodysostosis |
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| *[[Crohn's disease]] | | *[[Crohn's disease]] |
| *[[Cytomegalovirus]] | | *[[Cytomegalovirus]] |
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| *[[Gastrointestinal duplications]] | | *[[Gastrointestinal duplications]] |
| *[[Giardiasis]] | | *[[Giardiasis]] |
| | *[[Haemorrhagic disease of the newborn]] |
| *[[Haemorrhoids]] | | *[[Haemorrhoids]] |
| *[[Helicobacter pylori]] | | *[[Helicobacter pylori]] |
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| *[[Hemobilia]] | | *[[Hemobilia]] |
| *[[Hemophilia]] | | *[[Hemophilia]] |
| *[[Haemorrhagic disease of the newborn]]
| |
| *[[essential thrombocytosis|Hemorrhagic thrombocythemia]] | | *[[essential thrombocytosis|Hemorrhagic thrombocythemia]] |
| *[[Henoch-Schoenlein purpura]] | | *[[Henoch-Schoenlein purpura]] |
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| *[[Hepatorenal tyrosinemia]] | | *[[Hepatorenal tyrosinemia]] |
| *[[Hereditary haemorrhagic telangiectasia]] | | *[[Hereditary haemorrhagic telangiectasia]] |
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| *[[Herpes simplex virus]] | | *[[Herpes simplex virus]] |
| *[[Indomethacin]] | | *[[Indomethacin]] |
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| *[[Quinidine]] | | *[[Quinidine]] |
| *[[telangiectasia|Radiation-induced telangiectasia]] | | *[[telangiectasia|Radiation-induced telangiectasia]] |
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| *[[Chronic renal failure]]
| |
| *[[esophageal varices|Ruptured esophageal varices]] | | *[[esophageal varices|Ruptured esophageal varices]] |
| *[[Schistosoma mansoni]] | | *[[Schistosoma mansoni]] |
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
|
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
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| Miscellaneous
|
Foreign body, swallowed maternal blood
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Causes in Alphabetical Order
References
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