Haematemesis HPC

Question 1

Haematemesis How much blood?

Answer 1

Shows how much of an emergency

Question 2

Haematemesis character of vomit?

Answer 2

Fresh blood suggests upper GI, coffee ground is partially digested in stomach.

Question 3

Haematemesis malaena or frank blood in stools?

Answer 3

Malaena is due upper GI haemorrhage and digestion of blood, fresh blood is lower GI haemorrhage profuse fast upper GI.

Question 4

Haematemesis triggered by forceful vomit?

Answer 4

Suspect Mallory Weiss or Boerhaves.

Question 5

Haematemesis recent weight loss?

Answer 5

Upper GI malignancy.

Question 6

Haematemesis problems swallowing?

Answer 6

oesophageal malignancy

Question 7

Haematemesis Easy bruising, distended abdoemen, puffy ankles, lethargy?

Answer 7

Suspect liver failure. Could explain bleeding tendencies or if liver is cirrhotic, explain oesophageal varices.

Question 8

Haematemesis epigastric pain?

Answer 8

Gnawing pain suggests gastric carcinoma, whilst episodic dyspepsia suggests GORD (ask about heartburn/waterbrash).