haematemesis and melena Flashcards
A 45 year old man vomits several times after returning from a public house. He eventually vomits up a large
quantity of fresh blood and feels faint.
Mallory-Weiss tear
A 76 year-old lady presents to hospital with severe anaemia, Hb 4.6g/dl. He has been unwell for two months with anorexia and weight loss of 6kg. She has had no abdominal pain. Recently she has noticed that her bowel movements are dark in colour.
gastric CA
A 50 year old male with a previous history of intravenous drug use attended hospital with recent onset of jaundice and ascites. Shortly after arriving in hospital he vomited fresh blood and was found to have a pulse rate of 124 per minute and BP of 80 systolic with an un-recordable diastolic pressure.
oesophageal varices
A 70 year old male was seen with a history of two minor episodes of vomiting fresh blood. He had a past history of angina, cerebral transient ischaemic attack and repair of an abdominal aortic aneurysm. Medication consisted of atenolol and aspirin. Later he suddenly became sweaty and markedly hypotensive.
aorto-enteric fistula
A 37 year old woman was seen with a second episode of haematemesis six months after first presentation. She looked pale but otherwise well. A peptic ulcer had been diagnosed six months ago at endoscopy and she had been given a course of eradication therapy for Helicobacter pylori infection. There was no record of subsequent follow up.
duodenal ulcer