ABSTRACT
Bleeding from the gastrointestinal (GI) tract is a common reason for acute medical admission. It may present with the vomiting of fresh blood, or of altered blood that has the appearance of coffee grounds. Gastrointestinal bleeding may arise from conditions that are localised to one part of the gut, or from more generalised conditions that can potentially affect the whole GI tract. The main mechanisms responsible for gastrointestinal bleeding are mechanical, chemical or radiation injury, neoplasia, infection, inflammation, vascular disorders and other structural disorders. Selective arteriography with embolisation of the bleeding vessel or intra-arterial vasopressin injection is a further treatment option for intractable haemorrhage. Capsule enteroscopy is used to image the small bowel if no cause of bleeding is demonstrated during the initial investigations. Angiography or computed tomography angiography may be used to localise the feeding vessel to a bleeding point in the gut. The culprit vessel may then be occluded by embolisation or intra-arterial vasopressin injection.
