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However, aside from the melena itself, many patients may present with few symptoms.
It has a characteristic tarry colour and offensive smell, and is often difficult to flush away, which is due to the alteration and degradation of blood by intestinal enzymes.
In this article, we shall look at the differential diagnosis, clinical features and investigations for melena.
Variceal Bleeds Oesophageal varices refer to dilations of the porto-systemic anastomoses in the oesophagus.
Differential Diagnosis Melena usually occurs as a result of an upper gastrointestinal bleed rarely it can be due to bleeding in the small intestine or ascending colon.
Once the patient is stable or initial resuscitation attempts have proved ineffective and more invasive management for resuscitation is required , an endoscopy should be arranged.
Only blood that originates from a more proximal source such as the , or bleeding from a lower source that occurs slowly enough to allow for enzymatic breakdown, is associated with melena.