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When there is significant blood loss over a short time, symptoms may include vomiting red blood, vomiting black blood, bloody stool, or black stool. [1] Small amounts of bleeding over a long time may cause iron-deficiency anemia resulting in feeling tired or heart-related chest pain. [1]
This is a shortened version of the sixteenth chapter of the ICD-9: Symptoms, Signs and Ill-defined Conditions. It covers ICD codes 780 to 799. The full chapter can be found on pages 455 to 471 of Volume 1, which contains all (sub)categories of the ICD-9. Volume 2 is an alphabetical index of Volume 1.
Depending on the amount of the blood loss, symptoms may include shock. Upper gastrointestinal bleeding can be caused by peptic ulcers, gastric erosions, esophageal varices, and rarer causes such as gastric cancer. The initial assessment includes measurement of the blood pressure and heart rate, as well as blood tests to determine the hemoglobin.
A lower gastrointestinal bleed is defined as bleeding originating distal to the ileocecal valve, which includes the colon, rectum, and anus. [2] LGIB was previously defined as any bleed that occurs distal to the ligament of Treitz, which included the aforementioned parts of the intestine and also included the last 1/4 of the duodenum and the entire area of the jejunum and ileum. [1]
ICD-10 is the 10th revision of the International Classification of Diseases (ICD), a medical classification list by the World Health Organization (WHO). It contains codes for diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases. [1]
White blood cell count >10.5 in 98% (probably an overestimate as only tested in 81% of patients) Lactic acid elevated 91% (probably an overestimate as only tested in 57% of patients) In very early or very extensive acute intestinal ischemia, elevated lactate and white blood cell count may not yet be present.
Hematemesis is the vomiting of blood. [1] This is usually vomit that contains bright red blood. [2] Coffee ground vomiting is similar to hematemesis, but is distinct in not involving bright red blood. [3] Hematemesis must be differentiated from hemoptysis (coughing up blood) and epistaxis (nosebleed). [4] Both of these are more common conditions.
The differential diagnosis can be complicated somewhat if the person exhibits only vomiting or diarrhea (rather than both). [1] Appendicitis may present with vomiting, abdominal pain, and a small amount of diarrhea in up to 33% of cases. [1] This is in contrast to the large amount of diarrhea that is typical of gastroenteritis. [1]