Confounding aspects contributing to her low capillary blood glucose levels included blood loss due to melaena
and hypotension, which may have caused peripheral shunting of blood volume, as well as her long history of glucocorticoid use and possible adrenal insufficiency.
The occult bleeding is typical for capillary hemangiomas whereas cavernous ones cause profuse, relapsing hemorrhage manifested by melaena
(Huber et al., 2012).
Nausea, vomiting, belching, dyspepsia, bloating, chest discomfort, anorexia, haematemesis, &/or melaena
may also occur.
Laboratory features of VHF include leucopenia, thrombocytopenia and elevated transaminases, while coagulation profiles become progressively abnormal and overt haemorrhagic features (ecchymoses, epistaxis, gingival bleeding, melaena
, haematuria, etc.) may supervene from about day 5 after the onset of symptoms, or even earlier.
Duodenal carcinoid: a rare cause of melaena
in a cirrhotic patient.
The bleeding could be in mutiple forms such as haematemesis, coffee ground aspirates, melaena
, or haematochezia.
Scintigraphy with red blood cells (RBCs) labelled by means of [sup.[sup.99m]]Tc (T 1/2 6 hours) can help to detect the source of GI bleeding in the small intestine in patients with timely anamnesis of bleeding in the lower GI tract from an uncertain source (obscure-overt bleeding), melaena
and/or haematochezia and improves disease management.
Bleeding usually manifests as gingival bleeding, epistaxis, purpura, haematemesis, melaena
, haematuria, extensive ecchymoses, and in severe cases, subarachnoid or intracerebral haemorrhage.
They reported that among the fatalities, haematemesis, melaena
and somnolence were more common, the median platelet count was significantly lower (10,600/ml vs 20,000/ml), the mean PT (27 sec vs 16 sec) and mean aPTT (73 sec vs 44 sec) were longer, and the mean ALT level (1125 vs 331 IU/l), the mean AST level (3118 vs 913 IU/l) and the mean fibrinogen level (119 vs 340 IU/l) were higher.
2) residing in Village Shultanganj, PO Mahendru, District Patna, came with the complain of epigastric pain, with melaena
for the last five days and with a history of fever since last one month.
These rates are similar to rates of 1.02 to 1.04 for species with similar life histories, such as narwhal (Monodon monoceros), pilot whale (Globicephala melaena
), and spotted dolphin (Stenella plagiodon) (Kasuya et al., 1988; Kingsley, 1989; Barlow and Boveng, 1991).
On admission she was very pale and tired, she had passed large quantities of melaena
at home before being brought in by ambulance, and had already spent several hours in the emergency department.