Acute gastrointestinal hemorrhage. Part I. Approach to patients

Gastrointestinal hemorrhage is an important cause of morbidity and acute mortality in emergency practice. Emergency stabilization followed by definitive diagnosis and specific therapy often lead to successful outcomes. The signalment can be helpful in developing a differential diagnosis for patients with gastrointestinal hemorrhage. Acute onset of depression, diarrhea, vomiting, and hematochezia in a young puppy may suggest infectious enteritis. In patients with massive blood loss and cardiovascular collapse, an abbreviated physical examination may be required. When the patient has been stabilized, the minimum database should include complete blood cell count, serum chemistries, urinalysis, and fecal flotation and culture. Depending on the outcome of the initial medical investigation, additional diagnostic tests might be required. In patients in which a definitive diagnosis is still not forthcoming, imaging studies and gastrointestinal endoscopy should be considered.