Upper Gl bleeding Minimal and self - limited? ( see text) Yes Minor mucosal lesion Epistaxis No No < Gastric aspirate with gross blood or coffee-ground material? Yes Persistent or recurrent bleeding ? Yes No ’' Admit, endoscopy Mucosal lesions (Table 33.1) Esophageal varices Admit, upper Gl x -ray Mucosal lesions ( Table 33.1) Esophageal varices FIGURE 33.2 Diagnostic approach to upper gastrointestinal (GI) bleeding