© 2004 Fellowship of Postgraduate Medicine
SELF ASSESSMENT QUESTION
Gastroenterology
Upper gastrointestinal haemorrhage
Department of Gastroenterology, Leeds General Infirmary, Leeds, UK
Correspondence to:
Correspondence to:
Dr C H Lim
Department of Gastroenterology, Room 190A, Clarendon Wing, The General Infirmary at Leeds, Great George Street, Leeds LS1 3EX, UK; ch.lim@virgin.net
Accepted 15 October 2003
Answers on p 494.
| The first 150 words of the full text of this article appear below. |
A 75 year old man presented with a three day history of melaena without any abdominal pain. He had one episode of haematemesis (about 100 ml blood) in the emergency room. He had no previous history of peptic ulcer disease but had significant heart disease with coronary arterial by pass graft in 1992, poor left ventricular function, paroxysmal atrial fibrillation, and type 2 diabetes. His regular medications included aspirin, warfarin, bisoprolol, bumetamide, amiodarone, lisinopril, and metformin. He was tachycardic with a pulse of 110 beats/min and blood pressure of 110/66 mm Hg. No abdominal tenderness was noted on examination and rectal examination revealed black tarry stool.
Laboratory tests showed a haemoglobin of 93 g/l (135–180) and international normalised ratio of 3.0. He was initially treated with 5 mg of vitamin K intravenously, fresh frozen plasma, and blood transfusion. An urgent upper gastrointestinal endoscopy showed excess altered and clotted blood
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Upper gastrointestinal haemorrhage
Postgrad. Med. J. 2004 80: 494.[Extract] [Full Text] [PDF]
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