Gastrointestinal haemorrhage

Acute blood loss in gastrointestinal cancers is less common than chronic bleeding resulting in iron deficiency. It can occur as the presenting feature or in the terminal phase of illness in the heavily pre-treated patient. Haemorrhage occurs most often from the primary tumour or as a result of its local extension. Previous chemotherapy and clotting factor deficiency, in the case of hepatic impairment, may exacerbate bleeding. Endoluminal metastases are a rare cause of acute blood loss and metastases to the small bowel can occur in malignant melanoma.

Presentation may be with haematemesis, melaena, or fresh rectal bleeding, depending on the site of the lesion.

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