Melena

Melena (synonym: "Chernukha", tarry stools) - a loose black stools, reminiscent of the tar, with fetid smell. Melena is the most important symptom bleeding from the upper gastrointestinal tract. The causes of the Melun - Cm. Hematemesis. Bleeding from the gastrointestinal tract occur bloody vomiting, followed melenos and melenos without bloody vomiting. Dark color of stool at Melun is due to the formation of iron sulfide in the result of interaction of the collapsed hemoglobin with hydrogen sulphide. Bright red blood in stool does not exclude the localization of the source of bleeding in the upper gastrointestinal channel with accelerated peristalsis. Therefore, the color of stool depends on the residence time of blood in the bowel, and not from the site of bleeding. Melena may not be reliable sign of massive bleeding.
The clinical picture in the gastro-intestinal bleeding is closely connected with the number streamed blood. If the bleeding is minor patients feel some weakness. When massive hemorrhage come severe weakness, dizziness; patients pale, covered in a cold sweat, the heart rate increases, blood pressure falls. The amount of hemoglobin and the number of red blood cells immediately after the start of the bleeding cannot serve as an indicator of the magnitude of blood loss, because their decline occurs in 24-48 hours. Death may occur in a single profuse bleeding with symptoms of collapse (see).
Diagnosis melena is not that difficult. Even if the nurse did not see the Melun, and the clinical picture and the description of the type of stool in patients indicate Melun, the patient should be sent to the hospital for an accurate diagnosis and identification of the main disease. Not to be confused with melenos cases when the feces normal consistence is painted in black colour under the influence of the composition of food (black currant, blueberry, red wine), as well as some medications (bismuth, iron).
Treatment. The patient should be immediately taken to the surgery Department on a stretcher. To send the patient to the hospital he must be in a state of complete rest in bed, on my stomach, put an ice pack, prohibit and fluid intake. It is injected intramuscularly 1 ml of 1% solution vikasola.

Melena (gr. melaina, from melanos - dark, black; synonym: "Chernukha", tarry stools) - a loose black stools, reminiscent of the tar, with fetid smell. Melena is the most important symptom of internal bleeding from any of the digestive tract.
The causes of the emergence of melena - see Hematemesis.
Bleeding from the gastrointestinal tract may occur bloody vomiting, followed melena, and M. without bloody vomiting. Previously believed that if M has appeared without bloody vomiting, the source of bleeding is distal to the pyloric stomach. Observations of recent years refute this position. Melena without bloody vomiting may be in the localization of the pathological process (ulcer, cancer) in the stomach, and liver cirrhosis.
Sulfur iron, formed in the intestines of hemoglobin under the influence of enzymes, leads to a dark color of stool at Melun. The presence of red blood in stool does not exclude the localization of the source of bleeding in the upper intestine; the fast-peristalsis and associated rapid movement of blood from the upper sections of the bowel bowel movements may contain red blood. Therefore, the color of stool depends on the residence time of blood in the bowel, and not from the site of bleeding. M. cannot be a reliable sign of massive bleeding.
The clinical picture in the gastro-intestinal bleeding is closely connected with the number streamed blood. The intensity of blood loss can be judged by the General appearance of the patient, the color of skin and mucous membranes, frequency and nature of pulse and blood pressure. The amount of hemoglobin and the number of red blood cells in the first two days from the start of the bleeding cannot be indicators of the magnitude of blood loss, because their decline occurs in 24-48 hours.
In the first days after bleeding in some patients detected azotemia vnepochechny origin, higher temperatures (up to subfebrile and moderate fever), which is associated with the absorption of proteins in the blood from the intestines.
Death may occur in a single profuse bleeding with symptoms of collapse (see), shock (see).
The diagnosis of the main disease in the presence of melena often difficult for doctors. Great help in the diagnosis have carefully collected anamnesis, laboratory, endoscopic and x-ray methods. Remember that the color of normal bowel movements may influence the composition of food and also some medications that the patient is taking. Black currant, bilberries, red wine, rich or exclusively meat meal give the stool in a dark color. Some medicinal substances (bismuth, iron, animal black) also change color of stool (in black colour). If you suspect a Melun should produce chemical analysis of stool for blood (see Benzidine test, Guaiac test).
The appearance of M. and in relatively good condition of the patient should be alarming to the doctor because it may be a symptom of severe pathological process and subsequently become threatening.
The patient does need emergency care, hospitalization and detailed inspection. Treatment melena - see Hematemesis.