- Upper GI Bleed = Proximal to ligament of Treitz (suspensory muscle that holds the duodenum)
- Lower GI Bleed = Distal to ligament of Treitz
- Factors most predictive of an upper GI source
- Hx of Melena
- Hematochezia is usually due to lower GI Bleed, But it can still occur with massive upper GI bleeding!
- Coffee ground emesis
- Ratio BUN:Cr >30
- Hx of Melena
SCVMC IM Chief Resident Blog 