Hematemesis

}} Hematemesis (American English) or haematemesis (International English) is the vomitingof fresh red blood. The source is generally the upper gastrointestinal tract. Patients can easily confuse it with hemoptysis(coughing up blood), although the former is more common.

Causes

Causes can be:

• Vomiting of ingested blood after hemorrhagein the oral cavity, nose or throat
• Mallory-Weiss syndrome(esophageal tear)
• Esophageal varices
• Peptic ulcer
• Gastritis
• Gastric varices

Management

Hematemesis is treated as a medical emergency. The most vital distinction is whether there is blood loss sufficient to cause shock.

Minimal blood loss

If this is not the case, the patient is generally administered a proton pump inhibitor(e.g. omeprazole), given blood transfusions(if the level of hemoglobinis extremely low, that is less than 8.0 mg/dL or 4.5-5.0 mmol/L), and kept nil per osuntil esophagogastroduodenoscopy(EGD, endoscopy) can be arranged. Adequate venous access (large-bore cannulasor a central venous catheter) is generally obtained in case the patient suffers a further bleed and becomes unstable.

Significant blood loss

In a "hemodynamically significant" case of hematemesis resuscitation is an immediate priority to prevent cardiac arrest. Fluids and/or blood is adminstered, preferably by central venous catheter, and the patient is prepared for emergency endoscopy, which is typically done in theatres. Surgicalopinion is usually sought in case the source of bleeding cannot be identified endoscopically, and laparotomyis necessary.

See also

• Upper gastrointestinal bleed
• Shock

External links

• NIH/Medline

This article is licensed under the GNU Free Documentation License.
It uses material from the http://en.wikipedia.org/wiki/Hematemesis Wikipedia article Hematemesis.