The upper gastrointestinal tract includes the esophagus, stomach and duodenum. Upper gastrointestinal bleeding usually bleeds in a relatively large amount, vomiting fresh blood, and massive bleeding refers to blood loss exceeding 1000ml, whose clinical manifestations are mainly vomiting blood and black stools, often accompanied by reduced blood volume, which is very likely to cause shock, and belongs to is a common emergency. The common causes are: 1. gastrointestinal diseases, such as esophagitis, peptic ulcer, occupying lesions of the gut, Crohn’s disease. 2. portal hypertension can also cause gastrointestinal bleeding, such as portal phlebitis, hepatic venous obstruction syndrome. 3. diseases of adjacent organs or tissues of the gastrointestinal tract, such as gallbladder stones, liver cancer, pancreatic cancer, mediastinal tumors breaking into the esophagus. 4. systemic diseases, such as leukemia, uremia, thrombocytopenic purpura, thrombocytopenia, thrombocytopenia. 5. Stress ulcers after respiratory failure and resuscitation, upper gastrointestinal bleeding after major surgery, trauma and burns. Therefore, there are many causes of upper gastrointestinal bleeding, and it is important to identify the site and nature of bleeding before proceeding to the next step of treatment. When a patient is in shock, the first step is to stop the bleeding and resist shock, then find out the site of bleeding and carry out targeted treatment.