Ruptured Peptic Ulcer

Question 1

Presentation of ruptured peptic ulcer?

Answer 1

Background of PUD (long-term NSAID/bisphos use, H. pylori infection)
‘Coffee ground’ emesis
Melaena

Question 2

Investigations appropriate in suspected ruptured peptic ulcer?

Answer 2

Basic obs (reduced BP)
FBC & LFTs to rule out hepatic cause e.g. varices (both should be normal in RPU)

Question 3

Management of ruptured peptic ulcer?

Answer 3

Endoscopy (diagnostic + therapeutic)
- IM adrenaline at site of ulcer to stop bleeding
Then treat ulcer (PPI or triple therapy if H. pylori present)