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K92.1 Melaena (Tarry Stool) – Causes & Treatment
K92.1 is the ICD-10 code for melaena (tarry stool), a sign of bleeding in the upper gastrointestinal tract. The black, tar-like stool is caused by digested blood.
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K92.1 is the ICD-10 code for melaena (tarry stool), a sign of bleeding in the upper gastrointestinal tract. The black, tar-like stool is caused by digested blood.
What does ICD-10 Code K92.1 mean?
The ICD-10 code K92.1 refers to melaena – commonly known as tarry stool. Melaena describes black, tar-like, foul-smelling stools caused by digested blood passing through the gastrointestinal tract. The code belongs to the category of other diseases of the digestive system (K92) in the ICD-10 classification system.
Causes
Melaena is typically caused by bleeding in the upper gastrointestinal tract, including the oesophagus, stomach, or duodenum. Common causes include:
- Gastric ulcer (Ulcus ventriculi): Ulcerative lesions of the stomach lining
- Duodenal ulcer (Ulcus duodeni): Ulcerative lesions in the duodenum
- Oesophageal varices: Dilated veins in the oesophagus, often associated with liver cirrhosis
- Gastritis: Inflammation of the stomach lining
- Mallory-Weiss syndrome: Mucosal tears at the gastro-oesophageal junction
- Use of medications such as NSAIDs (non-steroidal anti-inflammatory drugs) or anticoagulants
- Tumours or carcinomas of the upper digestive tract
Symptoms and Presentation
The hallmark of melaena is black, tar-like stool with a characteristically sweet, putrid odour. This occurs because blood is broken down into haematin by gastric acid and intestinal bacteria as it passes through the digestive tract. Associated symptoms may include:
- Dizziness and weakness
- Pallor
- Rapid heartbeat (tachycardia)
- Drop in blood pressure
- Nausea or vomiting (possibly with blood: haematemesis)
- Abdominal pain or pressure in the upper abdomen
Diagnosis
Diagnosis is based on a combination of medical history, physical examination, and diagnostic procedures:
- Oesophagogastroduodenoscopy (OGD): Upper endoscopy is the most important diagnostic measure and also allows therapeutic intervention.
- Blood count: Assessment of haemoglobin, haematocrit, and coagulation status
- Faecal occult blood test (Haemoccult)
- Imaging such as ultrasound or CT scan if the source of bleeding is unclear
Treatment
Treatment depends on the underlying cause and the severity of the bleeding:
- Endoscopic haemostasis: Injection therapy, clip placement, or coagulation during OGD
- Medications: Proton pump inhibitors (e.g. pantoprazole) to reduce acid secretion; haemostatic agents
- Volume replacement: Intravenous fluids or blood transfusions in cases of significant blood loss
- Surgical intervention: In cases of uncontrollable bleeding
- Treatment of the underlying condition (e.g. Helicobacter pylori eradication for peptic ulcer disease)
When to seek medical attention?
Tarry stool is always a medical emergency and requires immediate medical evaluation. Affected individuals should seek medical attention promptly or call emergency services (e.g. 999 or 112), especially if accompanied by dizziness, a drop in blood pressure, or loss of consciousness.
References
- World Health Organization (WHO): ICD-10 Classification of Mental and Behavioural Disorders – K92.1 Melaena. https://icd.who.int
- Laine L, Jensen DM. Management of patients with ulcer bleeding. American Journal of Gastroenterology. 2012;107(3):345–360. doi:10.1038/ajg.2011.480
- Gralnek IM et al. Diagnosis and management of nonvariceal upper gastrointestinal hemorrhage: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy. 2015;47(10):a1–a46.
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