Hi. Thanks for your query. Noted the history about your stepson having puking and pooping blood, lives in Guatemala and the Doctors could not figure out what is wrong. He needed blood transfusion. This limited history indicates that he has lost and is loosing a lots of blood. There are two problems on which the investigations will be based. 1) There is a possibility of hematological disorder and thus can be corrected only by correcting the deficiency. 2) Bleeding ulcer or lesion that needs to be found out so that it can be coagulated, cauterized or stitched. This needs upper GI Endoscopy, Colonoscopy and camera endoscopy. It happens so that the patient is usually not bleeding and then these investigations may not show something. Hence the contrast enhanced CT scan on a multi planer machine and show then the leaking spot. Diagnosis laparoscopy and SOS Laparotomy may help to get the cause and treat it at the same time. This way the diagnosis can be made and the bleeding lesion controlled to get the proper treatment. I am sure the Doctors are doing all these tests and the cause will be found and treated.