dear all

2 days female full term present with massive melena, HB 11 gm, recieved blood and plasma and after an hour another attack of massive melena and HB 4 gm ..again blood and attack after an hour and bloood and attack after hour and again HB 4gm and blood

what to do

Sounds like a real emergency to me!

Seek for major gastrointestinal etiology, such as malrotation and volvulus of the gut.

Consult the nearest surgeon asap and discuss further handling (radiology etc).

the case turns to be massive gangrene of the whole small bowel but no malrotation/volvolus and our surgeon think of mesentric artery thrombosis,, any idea of a similar case or any one ever saw it ...thanx dr alexander for the help..i really appraciate it