Haematemesis

Question 1

What is Haematemesis?

Answer 1

Vomiting blood, caused by bleeding from the upper part of the GI tract

Question 2

What are some emergency causes of Haematemesis?

Answer 2

Oesophageal varices, Gastic ulceration

Question 3

What are some non-emergency causes of haematemesis?

Answer 3

Mallory-weiss tear, oesophagitis, gastritis, gastric malignancy, Meckel’s diverticulum, vascular malformations

Question 4

What do you need to ask someone with Haematemesis?

Answer 4

Timing, frequency, volume of bleeding,, dyspepsia, dysphagia, odynophagia, past medical history, smoking, alcohol states, use of steroids, NSAIDs, anticoagulants or biphosphonates

Question 5

What investigations would you do for Haematemesis?

Answer 5

Routine bloods and VBG, anaemia may be shown, LFTs may show liver damage, group and save, oesophagogastroduodenoscopy (OGD), Erect chest X-ray if peptic ulcer suspected, CT abdomen with IV contrast

Question 6

What is the Glasgow- blatchford bleeding score?

Answer 6

Scoring system used to risk stratify patients admitted with an upper GI bleed

Question 7

What is the management for Haematemesis?

Answer 7

ABCDE assessment, IV resuscitation and blood group and save, OGD, depending on cause, maybe angio-embolism

Question 8

What is a Mallory Weiss tear?

Answer 8

severe vomiting that leads to minor haematemesis- tear in epithelial lining of the oesophagus

Question 9

What is oesophagitis?

Answer 9

Inflammation of the intraluminal epithelial layer of the oesophagus usually due to GORD or infections or medications, radiotherapy, toxic substances or crohns

Question 10

What are oesophageal varices?

Answer 10

Dilations of the porto-systemic venous anastomoses in the oesophagus, if they rupture can cause haemorrhage, usually caused by portal hypertension

Question 11

What is gastric ulceration?

Answer 11

erosion into the blood vessels supplying the upper GI tract (usually posterior duodenum or lesser curve of the stomach)