Haematemesis

Question 1

Haematemesis define?

Answer 1

Vomiting of blood

Question 2

Haematemesis first action?

Answer 2

ABCDE

Question 3

Haematemesis location?

Answer 3

Haematemesis is due to bleeding in the upper GI tract = proximal to the ligament of Treitz that demarcates the boundary between the duodenum and jejunum.

Question 4

Haematemesis likely causes?

Answer 4

Question 5

Haematemesis varices pre-endoscopy treatment?

Answer 5

terlipressin and prophylactic antibiotics in pre-endoscopy management.

Question 6

Haematemesis Scoring systems?

Answer 6

Rockall score = Developed to predict the risk of rebleeding and mortality in patients with upper GI haemorrhage ; age, HR, BP, comorbitities. Blatchford score = same ; urea, hb, BP.

Question 7

Haematemesis mortality?

Answer 7

10%

Question 8

Haematemesis reason for emergency endoscopy?

Answer 8

Emergency endoscopy should be performed if patient has continual bleeding, oesophageal varices is thought to be the cause, the patient scores a high Rockall or has an aortic graft

Question 9

Haematemesis + aortic graft likely cause?

Answer 9

Aortic-enteric fistula

Question 10

Haematemesis Aortic graft other investigations?

Answer 10

Chest CT

Question 11

Haematemesis chest Xray findings (2)?

Answer 11

left sided pleural effusion for Beorhaaves perforation and pneumoperitoneum for perforated peptic ulcer.

Question 12

Pneumoperitionuim Xray

Answer 12

shows perforated gastric ulcer