Upper Gastrointestinal Bleeding - Causes

Causes

A number of medications increase the risk of bleeding including NSAIDs and SSRIs. SSRIs double the rate of upper gastrointestinal bleeding.

There are many causes for upper GI hemorrhage. Causes are usually anatomically divided into their location in the upper gastrointestinal tract.

People are usually stratified into having either variceal or non-variceal sources of upper GI hemorrhage, as the two have different treatment algorithms and prognosis.

The causes for upper GI hemorrhage include the following:

• Esophageal causes:
  • Esophageal varices
  • Esophagitis
  • Esophageal cancer
  • Esophageal ulcers
  • Mallory-Weiss tear

• Gastric causes:
  • Gastric ulcer
  • Gastric cancer
  • Gastritis
  • Gastric varices
  • Gastric antral vascular ectasia
  • Dieulafoy's lesions
• Duodenal causes:
  • Duodenal ulcer
  • Vascular malformation, including aorto-enteric fistulae. Fistulae are usually secondary to prior vascular surgery and usually occur at the proximal anastomosis at the third or fourth portion of the duodenum where it is retroperitoneal and near the aorta.
  • Hematobilia, or bleeding from the biliary tree
  • Hemosuccus pancreaticus, or bleeding from the pancreatic duct
  • Severe superior mesenteric artery syndrome