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Melena

MedGen UID:
505170
Concept ID:
CN002040
Finding
 

Definition

The passage of blackish, tarry feces associated with gastrointestinal hemorrhage. Melena occurs if the blood remains in the colon long enough for it to be broken down by colonic bacteria. One degradation product, hematin, imbues the stool with a blackish color. Thus, melena generally occurs with bleeding from the upper gastrointestinal tract (e.g., sotmach ulcers or duodenal ulcers), since the blood usually remains in the gut for a longer period of time than with lower gastrointestinal bleeding. [from HPO]

Recent clinical studies

Etiology

Soukoulis IW, Liang MG, Fox VL, Mulliken JB, Alomari AI, Fishman SJ
J Pediatr Gastroenterol Nutr 2015 Oct;61(4):415-20. doi: 10.1097/MPG.0000000000000812. PMID: 25859824
Miller PE, Gelber AC, Houston BA
Gastroenterology 2014 Jun;146(7):1606-7. Epub 2014 Apr 19 doi: 10.1053/j.gastro.2014.01.066. [Epub ahead of print] PMID: 24755341
Etzel JP, Williams JL, Jiang Z, Lieberman DA, Knigge K, Faigel DO
Gastrointest Endosc 2012 Apr;75(4):819-26. Epub 2012 Jan 31 doi: 10.1016/j.gie.2011.11.041. [Epub ahead of print] PMID: 22301339Free PMC Article
Motoki T, Naomoto Y, Hoshiba J, Shirakawa Y, Yamatsuji T, Matsuoka J, Takaoka M, Tomono Y, Fujiwara Y, Tsuchita H, Gunduz M, Nagatsuka H, Tanaka N, Fujiwara T
World J Gastroenterol 2011 Feb 14;17(6):717-26. doi: 10.3748/wjg.v17.i6.717. PMID: 21390141Free PMC Article
Palamidessi N, Sinert R, Falzon L, Zehtabchi S
Acad Emerg Med 2010 Feb;17(2):126-32. doi: 10.1111/j.1553-2712.2009.00609.x. PMID: 20370741

Diagnosis

Cotter TG, Al-Bawardy B, Loftus CG
Mayo Clin Proc 2015 Aug;90(8):e83-7. doi: 10.1016/j.mayocp.2015.01.026. PMID: 26250736
Lin PY, Tsai JR, Chang CC
Gastroenterology 2015 Mar;148(3):e10-1. Epub 2015 Jan 28 doi: 10.1053/j.gastro.2014.09.043. [Epub ahead of print] PMID: 25637837
Tofts R, Kory P, Acquah S
Chest 2014 Oct;146(4):e130-3. doi: 10.1378/chest.13-1822. PMID: 25288005
Street R, Brady J, Slobodav G
J Okla State Med Assoc 2013 Dec;106(12):477-9. PMID: 24620413
Fan Y, Wu SD, Kong J
World J Gastroenterol 2013 Apr 7;19(13):2126-8. doi: 10.3748/wjg.v19.i13.2126. PMID: 23599637Free PMC Article

Therapy

Tofts R, Kory P, Acquah S
Chest 2014 Oct;146(4):e130-3. doi: 10.1378/chest.13-1822. PMID: 25288005
Miller PE, Gelber AC, Houston BA
Gastroenterology 2014 Jun;146(7):1606-7. Epub 2014 Apr 19 doi: 10.1053/j.gastro.2014.01.066. [Epub ahead of print] PMID: 24755341
Carbone M, Buccisano F, Lenci I, Baiocchi L
Dig Liver Dis 2013 Jan;45(1):e1. Epub 2012 Aug 28 doi: 10.1016/j.dld.2012.07.010. [Epub ahead of print] PMID: 22951315
Sakuma Y, Yazumi S, Fukunaga T, Yamamoto A, Hamuro M, Nakamura K
Gastrointest Endosc 2011 Aug;74(2):404-6. Epub 2011 May 31 doi: 10.1016/j.gie.2011.03.1240. [Epub ahead of print] PMID: 21624583
Motoki T, Naomoto Y, Hoshiba J, Shirakawa Y, Yamatsuji T, Matsuoka J, Takaoka M, Tomono Y, Fujiwara Y, Tsuchita H, Gunduz M, Nagatsuka H, Tanaka N, Fujiwara T
World J Gastroenterol 2011 Feb 14;17(6):717-26. doi: 10.3748/wjg.v17.i6.717. PMID: 21390141Free PMC Article

Prognosis

Miller PE, Gelber AC, Houston BA
Gastroenterology 2014 Jun;146(7):1606-7. Epub 2014 Apr 19 doi: 10.1053/j.gastro.2014.01.066. [Epub ahead of print] PMID: 24755341
Hashash JG, Francis FF
Gastroenterology 2013 Dec;145(6):e3-4. PMID: 24409489
Santos-Antunes J, Ramalho R, Lopes S, Macedo G
J Gastrointestin Liver Dis 2013 Dec;22(4):373. PMID: 24369315
Takahashi H, Nagatoshi Y, Kato M, Koh K, Kishimoto H, Kawai M, Fukuzawa R, Hanada R
J Pediatr 2012 Mar;160(3):524-524.e1. Epub 2011 Nov 9 doi: 10.1016/j.jpeds.2011.09.034. [Epub ahead of print] PMID: 22074937
Palamidessi N, Sinert R, Falzon L, Zehtabchi S
Acad Emerg Med 2010 Feb;17(2):126-32. doi: 10.1111/j.1553-2712.2009.00609.x. PMID: 20370741

Clinical prediction guides

Telaku S, Kraja B, Qirjako G, Prifti S, Fejza H
Turk J Gastroenterol 2014 Dec;25 Suppl 1:110-5. doi: 10.5152/tjg.2014.4351. PMID: 25910287
Edwards AL, Mönkemüller K, Pamboukian SV, George JF, Wilcox CM, Peter S
Endoscopy 2014 Nov;46(11):986-91. Epub 2014 Oct 7 doi: 10.1055/s-0034-1377512. [Epub ahead of print] PMID: 25290096
Miller PE, Gelber AC, Houston BA
Gastroenterology 2014 Jun;146(7):1606-7. Epub 2014 Apr 19 doi: 10.1053/j.gastro.2014.01.066. [Epub ahead of print] PMID: 24755341
Motoki T, Naomoto Y, Hoshiba J, Shirakawa Y, Yamatsuji T, Matsuoka J, Takaoka M, Tomono Y, Fujiwara Y, Tsuchita H, Gunduz M, Nagatsuka H, Tanaka N, Fujiwara T
World J Gastroenterol 2011 Feb 14;17(6):717-26. doi: 10.3748/wjg.v17.i6.717. PMID: 21390141Free PMC Article
Palamidessi N, Sinert R, Falzon L, Zehtabchi S
Acad Emerg Med 2010 Feb;17(2):126-32. doi: 10.1111/j.1553-2712.2009.00609.x. PMID: 20370741

Recent systematic reviews

Zhang H, Zhou YP, Peng HJ, Zhang XH, Zhou FY, Liu ZH, Chen XG
Biomed Res Int 2014;2014:359308. Epub 2014 Jul 1 doi: 10.1155/2014/359308. PMID: 25097856Free PMC Article
Srygley FD, Gerardo CJ, Tran T, Fisher DA
JAMA 2012 Mar 14;307(10):1072-9. doi: 10.1001/jama.2012.253. PMID: 22416103
Cioffi P, Antonelli D, Belfiglio M, Melena S, Petrelli F, Grappasonni I
J Oncol Pharm Pract 2012 Jun;18(2):207-12. Epub 2011 Oct 21 doi: 10.1177/1078155211424787. [Epub ahead of print] PMID: 22020659
Konrad G
Can Fam Physician 2010 Mar;56(3):229-38. PMID: 20228305Free PMC Article
Pignone M, Campbell MK, Carr C, Phillips C
Eff Clin Pract 2001 Jul-Aug;4(4):150-6. PMID: 11525101

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