Summary: Vomiting of blood that is either fresh bright red, or older "coffee-ground" in character. It generally indicates bleeding of the UPPER GASTROINTESTINAL TRACT.

Top Publications

  1. Palmer K. Management of haematemesis and melaena. Postgrad Med J. 2004;80:399-404 pubmed
    ..Intravenous omeprazole reduces the risk of re-bleeding in ulcer patients undergoing endoscopic therapy. Repeat endoscopic therapy or operative surgery are required if bleeding recurs...
  2. Yegane R, Bashtar R, Bashashati M. Aortoesophageal fistula due to caustic ingestion. Eur J Vasc Endovasc Surg. 2008;35:187-9 pubmed
    ..Caustic agent ingestion may produce corrosive lesions that can extend beyond adjacent organs. We report three cases of aortoesophageal fistulas (AEF) after caustic ingestion that were diagnosed by autopsy...
  3. Kato N, Tadanori H, Tanaka K, Yasuda F, Iwata M, Kawarada Y, et al. Aortoesophageal fistula-relief of massive hematemesis with an endovascular stent-graft. Eur J Radiol. 2000;34:63-6 pubmed
    A 59-year-old man with an esophageal carcinoma developed massive hematemesis due to aortoesophageal fistula after irradiation therapy reached 58 Gy...
  4. Archimandritis A, Hatzopoulos N, Hatzinikolaou P, Sougioultzis S, Kourtesas D, Papastratis G, et al. Jejunogastric intussusception presented with hematemesis: a case presentation and review of the literature. BMC Gastroenterol. 2001;1:1 pubmed
    ..Jejunogastric intussusception (JGI) is a rare but potentially very serious complication of gastrectomy or gastrojejunostomy. To avoid mortality early diagnosis and prompt surgical intervention is mandatory...
  5. Newman R, Fleshner P, Lajam F, Kim U. Esophageal tuberculosis: a rare presentation with hematemesis. Am J Gastroenterol. 1991;86:751-5 pubmed
    ..Patients usually present with progressive dysphagia or odynophagia. We report a patient with hematemesis that was later attributed to the erosion of tuberculous subcarinal lymph nodes into the esophagus...
  6. Harikumar R, Harish K, Aravindan K, Thomas V. Testicular choriocarcinoma with gastric metastasis presenting as hematemesis. Indian J Gastroenterol. 2004;23:223-4 pubmed
    We report a 28-year-old man who presented with hematemesis due to choricarcinoma of testis metastatic to the stomach. Gastroscopy showed a polypoidal lesion...
  7. Jeyamani R, Shyamkumar N, Narayanan K, Subhash H, George B, Kurian G. Giant splenic artery mycotic aneurysm presenting with massive hematemesis. Indian J Gastroenterol. 2003;22:147-8 pubmed
    We report a 40-year-old man with rheumatic heart disease who presented with abdominal pain for three weeks and hematemesis for 24 hours. CT scan showed a large splenic artery aneurysm without evidence of pancreatitis...
  8. Chetty R, Sabaratnam R. Upper gastrointestinal bacillary angiomatosis causing hematemesis: a case report. Int J Surg Pathol. 2003;11:241-4 pubmed
    A 38-year-old HIV-positive woman presented with massive hematemesis on initial admission to hospital. Endoscopy revealed ulcerated nodular lesions in the esophagus, stomach, and duodenum. The clinical impression was of Kaposi's sarcoma...
  9. Aanpreung P, Atisook K. Hematemesis in infants induced by cow milk allergy. Asian Pac J Allergy Immunol. 2003;21:211-6 pubmed
    ..the histology of the gastrointestinal mucosa, the treatments and the clinical course in infants who had hematemesis induced by cow milk allergy. The medical records were reviewed retrospectively...

Scientific Experts

More Information


  1. Bural G, Scheetz M, Laymon C, Mountz J. Tc-99m red blood cell bleeding scan in a pregnant woman presenting with hematemesis: a brief review of indications and guidelines for radionuclide scans during pregnancy. Clin Nucl Med. 2011;36:987-90 pubmed publisher
    A 6-month pregnant 35-year-old woman with hematemesis and dark blood in her stool was evaluated for location of an active gastrointestinal bleeding site. The findings from 2 esophagogastroduodenoscopies and a colonoscopy were negative...
  2. Dawson M, Polizzotto M, Gordon A, Roberts S, Spencer A. Extramedullary relapse of multiple myeloma presenting as hematemesis and melena. Nat Clin Pract Oncol. 2006;3:223-6; quiz 227 pubmed
    ..She presented with hematemesis and melena following salvage chemotherapy with dexamethasone, cyclophosphamide, etoposide, cisplatin, and ..
  3. Bird M, Amjadi D, Behrns K. Primary splenic lymphoma complicated by hematemesis and gastric erosion. South Med J. 2002;95:941-2 pubmed
    ..Upper intestinal hemorrhage can be successfully treated with splenic artery embolization, followed by splenectory and gastric resection...
  4. Munteanu M, Pirşcoveanu M, Mănescu P, Biciuşci V, Petrescu F, Munteanu M, et al. Intussusception of efferent intragastric loop after gastrojejunostomy--an exceptional cause of high occlusion and hematemesis. Chirurgia (Bucur). 2006;101:525-8 pubmed
    ..severe pain in the superior abdominal segment posteriorly irradiated, incoercible biliary nausea followed by hematemesis. The endoscopic, imaging and biological explorations suggested a huge gastric tumor that occupied the whole ..
  5. Laposata M, Van Cott E, Lev M. Case records of the Massachusetts General Hospital. Case 1-2007. A 40-year-old woman with epistaxis, hematemesis, and altered mental status. N Engl J Med. 2007;356:174-82 pubmed
  6. Antiga E, Melani L, Caproni M, Fabbri P. An unusual cause of gastrointestinal bleeding in a young girl. CMAJ. 2006;175:583 pubmed
  7. Firstenberg M, Sai Sudhakar C, Sirak J, Crestanello J, Sun B. Intestinal ischemia complicating ascending aortic dissection: first things first. Ann Thorac Surg. 2007;84:e8-9 pubmed
    ..We present a case of acute ascending aortic dissection associated with an intra-abdominal vascular and enteric catastrophe that was successfully managed prior to aortic repair...
  8. Olaeta Elizalde R. [Nonvariceal upper gastrointestinal hemorrhage. Treatment options. What do I do? The internist]. Rev Gastroenterol Mex. 2007;72 Suppl 2:51-3 pubmed
  9. van der Veldt A, Hadithi M, Paul M, van den Berg F, Mulder C, Craanen M. An unusual cause of hematemesis: Goiter. World J Gastroenterol. 2006;12:5412-5 pubmed
    ..Bleeding from these varices is extremely rare. We describe a 77-year-old patient with hematemesis due to downhill varices as a result of recurrent goiter...
  10. Mumoli N, Cei M, Niccoli G. An unusual case of supraglottic bleeding (with video). Gastrointest Endosc. 2007;65:517, discussion 517 pubmed
  11. Briceno J, Naranjo A, Ciria R, Sanchez Hidalgo J, Zurera L, Lopez Cillero P. Late hepatic artery pseudoaneurysm: a rare complication after resection of hilar cholangiocarcinoma. World J Gastroenterol. 2008;14:5920-3 pubmed
    ..After a sudden and massive hematemesis, a multidetector computed tomographic angiography (MDCTA) showed a hepatic artery pseudoaneurysm...
  12. Filik L, Odemis B, Koklu S, Tola M, Yurdakul M, Sahin B. Arterioportal fistula causing jejunal variceal hemorrhage. Turk J Gastroenterol. 2003;14:266-9 pubmed
    ..He had had hematemesis four years previously and was diagnosed as esophageal variceal bleeding secondary to hepatic arterioportal ..
  13. Angiò L, Pirrone G, Fracassi M, Piazzese E, Pacilè V, Fabiano N, et al. [Massive hematemesis resulting from stomach rupture caused by pseudoaneurysm of the splenic artery in a patient with chronic pancreatitis. A case report]. Chir Ital. 2003;55:729-39 pubmed
    ..Only the combined, integrated efforts of the interventional radiologist and the surgeon can ensure rapid stabilisation of the bleeding and the desired improvement in survival...
  14. Rodrigues S, Bastos P, Macedo G. A rare cause of hematemesis: gastric metastases from renal cell carcinoma. Gastrointest Endosc. 2012;75:894; discussion 895 pubmed publisher
  15. Park W, Kim H, Jeon B, Kim S, Lee S. Should anticoagulants be administered for portal vein thrombosis associated with acute pancreatitis?. World J Gastroenterol. 2012;18:6168-71 pubmed publisher
    ..After one month of anticoagulation therapy, the patient developed severe hematemesis. With endoscopy and an abdominal computed tomography scan, hemorrhages in the pancreatic pseudocyst, which was ..
  16. Cheng X, Zhou D, Wei J, Zheng S. Regional portal hypertension, systemic lymphadenopathy, and splenomegaly associated with autoimmune pancreatitis. Clin Res Hepatol Gastroenterol. 2013;37:e75-80 pubmed publisher
    ..By the 6-month follow-up, the patient had recovered, the serum IgG had decreased to normal, and enhanced CT showed a normal pancreas. We speculate that splenectomy may be a new method of treating AIP...
  17. Mori S, Tagaya N, Hamada K, Nakagawa A, Sawada T, Honma K, et al. Undifferentiated carcinoma of the esophagus with rapid growth of lymph node. A case report and review of the literature. Tumori. 2008;94:411-5 pubmed
    ..The patient developed rapid growth of lymph nodes and died of massive hematemesis 2 months after the diagnosis. UCE is rare but highly malignant...
  18. Miyahara K, Ueki T, Mizuno M, Kobayashi S, Kajikawa N, Iwado S, et al. [Case of pseudoaneurysm ruptured into gallbladder and successfully treated with arterial embolization]. Nihon Shokakibyo Gakkai Zasshi. 2008;105:699-704 pubmed
    A 79-year-old man was admitted with hematemesis. Emergency upper gastrointestinal tract endoscopy revealed bleeding from the papilla of Vater. Computed tomography showed cholecystitis with a gallstone and a hematoma in the gallbladder...
  19. Di Mauro D, Sarli L, Roncoroni L. An exceptional postoperative gastric tube bleeding after esophageal resection for cancer. Dis Esophagus. 2009;22:E11-3 pubmed publisher
    ..The subsequent onset of a serious and intermittent hematemesis, which was endoscopically deemed to be the result of a hemorrhagic gastritis, required multiple blood ..
  20. Santo K, Guest P, McCafferty I, Bonser R. Aortoesophageal fistula secondary to stent-graft repair of the thoracic aorta after previous surgical coarctation repair. J Thorac Cardiovasc Surg. 2007;134:1585-6 pubmed
  21. Gologan E, Achiţei D, Balan G. [Budd-Chiari syndrome--case presentation]. Chirurgia (Bucur). 2011;106:395-400 pubmed
    ..in medical evidence for ten years with a Child A ethanolic liver cirrhosis, who was admitted in emergency for hematemesis and melena...
  22. Cavaliere F, Craba A, Caputo C, Gaspari R, Conti G, Proietti R. A normal response to Synachten test does not rule out corticosteroid effectiveness in weaning from catecholamine after septic shock. Minerva Anestesiol. 2007;73:367-70 pubmed
    ..A pharmacological effect was hypothesized; the contemporary increase of platelet, decrease of white blood cells, and decrease of plasma fibrinogen supported this hypothesis...
  23. Lambeck Y, van Westreenen H, Weusten B, Timmer R, Boerma D. [Haematemesis due to splenic vein thrombosis]. Ned Tijdschr Geneeskd. 2012;156:A4992 pubmed
    ..Splenic vein thrombosis may occur after pancreatitis and can lead to left-sided portal hypertension. Venous drainage from the spleen then occurs through the short gastric vessels, resulting in gastric varices...
  24. Jammal M, Khodorkovsky B, Raden M, Hahn B. Adult female with hematemesis-Dieulafoy lesion. Am J Emerg Med. 2013;31:889.e5-6 pubmed publisher
    A 40-year-old healthy woman presented to the emergency department with a complaint of intermittent hematemesis, despite the absence of usual factors associated with upper gastrointestinal bleeding (ie, nonsteroidal anti-inflammatory ..
  25. Parkash A, Cheema H, Malik H, Fayyaz Z. Congenital hepatic fibrosis: clinical presentation, laboratory features and management at a tertiary care hospital of Lahore. J Pak Med Assoc. 2016;66:984-8 pubmed
    ..To describe the clinical presentations, laboratory features and management of congenital hepatic fibrosis patients at a tertiary care hospital...
  26. Jain S, Jayant M, Norbu C, Garg P. Primary small gut volvulus in adult presenting with hematemesis. Indian J Gastroenterol. 2006;25:262-3 pubmed
    ..We report a 25-year-old man with primary small gut volvulus who presented with hematemesis. The gangrenous gut was resected at laparotomy. He is well 3 months later.
  27. Shetty S, Kalokhe S, Rathi P, Desai N, Sethna K, Rajyadhyaksha G, et al. Duodenal leiomyoma--a rare cause of haematemesis. J Assoc Physicians India. 2001;49:1114-5 pubmed
    ..They usually present with malena and anaemia, rarely hematemesis. We report a case of leiomyoma of duodenum diagnosed on endoscopic ultrasound that presented with massive ..
  28. Honjo O, Yamada Y, Arata T, Matsuno T, Kurokawa T, Kushida Y. A primary aorto-duodenal fistula associated with an inflammatory abdominal aortic aneurysm: a case report. Acta Med Okayama. 2005;59:161-4 pubmed
    ..A 52-year-old male presented with recurrent hematemesis. A computer tomography scan showed a sealed rupture of the AAA adjacent to the duodenum...
  29. Hung L, Lee Y, Yu S, Leung W, Sung J. A middle-aged woman with recurrent haemetemesis. Lancet. 2002;360:778 pubmed
  30. Ouedraogo N, Niakara A, Lougue Sorgho C. [Abdominal aortic aneurysm manifested by hematemesis in a 32 year old patient infected by HIV]. Med Trop (Mars). 2003;63:64-7 pubmed
    ..The presenting symptom was recurrent massive hematemesis. Diagnosis was suspected on the basis of clinical cardiovascular assessment and confirmed by ultrasonography ..
  31. Mahachai V, Vilaichone R, Wisedopas N. Malignant duodenal stromal tumor: the first case report in Thailand and review of the literature. J Med Assoc Thai. 2001;84 Suppl 1:S481-4 pubmed
    ..A high level of suspicion to detect this malignant tumor especially in a patient presenting with obscure gastrointestinal bleeding and effective surgical treatment allow better clinical outcome in this rare and fatal malignancy...
  32. Württenberger A, Barnert J, Wienbeck M. [Long-Lasting Odynophagia and Haematemesis - the Only Clinical Signs of a Pemphigus vulgaris]. Z Gastroenterol. 2002;40:419-24 pubmed
    ..Restriction of the lesions to the oesophagus without oropharyngeal and cutaneous manifestation - as we have seen in our patient - is rare...
  33. Kimpton J, Bowen J, Craigie R. Paediatric angiodysplasia of the jejunum: a case report and review of the literature. Scott Med J. 2012;57:247 pubmed publisher
    ..She remained well at six-month follow-up. This case highlights the importance of considering upper GIAD in an acute paediatric gastrointestinal bleed and the way in which surgical management can prevent a potentially fatal outcome...
  34. Tuncer K, Ozutemiz O. An unusual complication of esophageal variceal band ligation: iatrogenic esophageal foreign body. Endoscopy. 2003;35:460 pubmed
  35. Taranu T, Vintilă D, Neacşu N, Popa P, Lunca C, Crumpei F, et al. [Heterotopic accessory pancreas in surgical pathology: review of 23 years experience]. Chirurgia (Bucur). 2010;105:347-53 pubmed
    ..The abnormal presence of the pancreatic tissue in other digestive organs is rare but sometimes is the cause of some surgical diseases...
  36. Mrad S, Boukthir S, Gharsallah L, Bouyahia O, Faten F, Fetni I, et al. [Helicobacter pylori infection in childhood revealed by hematemesis: endoscopic and pathologic patterns]. Tunis Med. 2007;85:930-4 pubmed
    Helicobacter pylori infection frequency in hematemesis was scarcely studied.
  37. Fayad N, Nammour F, Elfant A. Endoscopic variceal ligation for bleeding duodenal varices. J Clin Gastroenterol. 2004;38:467 pubmed
  38. Sharma D, Gupta A, Jain B, Agrawal V, Dargan P, Upreti L, et al. Tuberculous gastric perforation: report of a case. Surg Today. 2004;34:537-41 pubmed
    ..The patient suffered a bout of hematemesis, following which an endoscopy showed a bleeding blood vessel at the edge of the perforation...
  39. Lee C, Yim M, Benndorf G. Traumatic pseudoaneurysm of the pharyngeal artery: An unusual cause of hematemesis and hematochezia after craniofacial trauma. Surg Neurol. 2006;66:444-6; discussion 446 pubmed
    Traumatic aneurysms of the internal maxillary artery are extremely rare. We report a case of traumatic pseudoaneurysm of the pharyngeal artery, a branch of the internal maxillary artery, presenting with hematemesis and hematochezia.
  40. Papagoras C, Kountouras J, Brilakis S, Chatzopoulos D, Zavos C, Topalidis A. Rheumatic-like syndrome as a symptom of underlying gastric cancer. Clin Rheumatol. 2007;26:1029-31 pubmed
    ..b>Hematemesis that occurred during her hospital stay led to an emergency endoscopy and the diagnosis of gastric ..
  41. Selinger C, Jones N, Parker C. Coffee ground vomit is difficult to identify. Eur J Gastroenterol Hepatol. 2007;19:825 pubmed
  42. Chiengthong K, Somboonnithiphol K, Kittipinyovath P, Chongsrisawat V, Poovorawan Y, Panyakhamlerd K, et al. Pregnancy in biliary atresia after kasai operation complicated by portal hypertension. J Med Assoc Thai. 2006;89:1961-4 pubmed
    ..At 32 weeks of gestation, she presented with severe hematemesis from variceal bleeding and had thrombocytopenia from hypersplenism...
  43. Adler D, Petersen B, Gostout C. Hemosuccus pancreaticus. Gastrointest Endosc. 2004;59:695 pubmed
  44. Maggio D, Barkun A, Martel M, Elouali S, Gralnek I. Predictors of early rebleeding after endoscopic therapy in patients with nonvariceal upper gastrointestinal bleeding secondary to high-risk lesions. Can J Gastroenterol. 2013;27:454-8 pubmed
  45. Kang T, Lee H, Yang F, Wang N. Idiopathic hepatic arterio-portal fistula: report of one case. Acta Paediatr Taiwan. 2002;43:102-5 pubmed
    ..We report a 9-year old boy with idiopathic hepatic arterio-portal fistula presented as intractable hematemesis due to esophageal and gastric varices...
  46. Pitcher G, Bowley D, Chasumba G, Zuckerman M. Life-threatening haemorrhage from a gastric Dieulafoy lesion in a child with haemophilia. Haemophilia. 2002;8:719-20 pubmed
  47. Eidem M, Gross G, Alley J, Cohn S, Deschner K. Gallstone ileus presenting with hematemesis. Gastrointest Endosc. 2007;66:596-7; discussion 597 pubmed
  48. Devarbhavi H, Alvares J. Polypoid gastric carcinoid tumor presenting as hematemesis with prolapse into the duodenum. Gastrointest Endosc. 2003;57:618-20 pubmed
  49. Kent A, O Beirne J, Negus R. The patient with haematemesis and melaena. Acute Med. 2011;10:45-9 pubmed
    ..The rising age of the population may also have offset further reductions in mortality and morbidity that may have otherwise come about through improved supportive and endoscopic care...
  50. Boujaoude J, Abboud B, Abadjian G. How to evaluate a gastric submucosal tumour in a patient with haematemesis?. Gut. 2005;54:629, 629 pubmed
  51. Wobser H, Scholmerich J, Buttner R. [19-year-old kick-boxer with hematemesis and splenomegaly]. Internist (Berl). 2010;51:213-8 pubmed publisher
    ..The patient underwent endoscopic therapy and portosystemic shunt operation (Warren-shunt) due to cavernous transformation and severe hypersplenism. Thereafter the patient remained asymptomatic...
  52. Chandran S, Parvaiz A, Karim A, Ghafoor I, Steadman B, Pearce N, et al. Ruptured left gastric artery aneurysm successfully treated by thrombin injection: case report and literature review. ScientificWorldJournal. 2005;5:20-3 pubmed
    ..A review of the literature for this rare condition is also presented...
  53. Sarkhy A. Gastroesophageal reflux disease in infants. Myths and misconceptions, where is the evidence?. Saudi Med J. 2012;33:593-600 pubmed
    ..GERD]) when symptoms become more severe or are associated with complications such as failure to thrive or hematemesis. Though it is a very common condition, there are several misconceptions and myths on GER/GERD diagnosis and ..