Journal of clinical gastroenterology
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Epistaxis was diagnosed in 10 patients with apparent upper gastrointestinal bleeding, comprising a 0.55% incidence of hematemesis and melena in the population studied. A sufficient amount of blood can be swallowed during epistaxis to cause hematemesis and melena. Recent facial trauma or epistaxis, absence of a history of chronic dyspepsia, and impairment of blood coagulation emerge as strong indicators of the diagnosis and should lead to a careful examination of the nose and nasopharynx for the source of bleeding.