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Model for End-Stage Liver Disease (MELD) for ages 12 and older
The Model for Liver Disease (MELD)
Liver Disease (MELD ... Liver Disease (MELD ... revision in the MELD ... The new MELD scores ... initial score (MELD
Upper Gastronintestinal Bleed - Differential Diagnosis Algorithm
Acute Hematemesis/Melena
 - Blood in vomitus?/black, tarry stools
 - If
Acute Hematemesis/Melena ... stools - If Melena ... #Hematemesis #Melena
Black and Bloody Stools - Melena and Hematochezia
Melena - Refers to passage of black, tarry (sticky
Bloody Stools - Melena ... and Hematochezia Melena ... In infants, melena ... #Melena #Hematochezia
Helpful Clues for Distinguishing Upper vs. Lower GI Bleeding
Upper GI Bleed (proximal to ligament of Treitz):
hematemesis and/or melena ... Can present with melena
Upper GI Bleed - Management Algorithm

Upper GI bleed Suspected: Melena, hematemesis, coffee-ground emesis, BRBPR
Initial Stabilization
Concern for
bleed Suspected: Melena
Acute Esophageal Necrosis
History: Hematemesis and/or melena (70%), Dysphagia, Epigastric/chest pain, Sepsis
Diagnosis EGD and Biopsy
Differential: Melanosis, Melanoma,
Hematemesis and/or melena
Lower GI Bleed - Management Algorithm

Suspected lower GI bleeding (LGIB):
 • Hematochezia 
 • Melena +
Hematochezia • Melena
The Gastroenterology Consult Primer
Guide to Calling a GI Consult
HPI:
 - Start with reason for consult
- Symptoms: Melena
The Liver Consult Primer - Guide to calling a consult
HPI:
 - Start with reason for consult
complications/ MELD ... bili/ current MELD
Tinea Versicolor - Physical examination revealed large, coalescing, hypopigmented patches and macules on her torso and
Melan-A staining