Hematemesis

Marc J. Kahn, MD

Tulane University School of Medicine, New Orleans, LA

Copyright of the American Society of Hematology, 2006. ISSN: 1931-6860.

This case was reviewed and updated in March 2012 by Dr. Howard Liebman and members of the Teaching Cases Subcommittee.

I. HISTORY

PATIENT PRESENTATION

A 64-year-old man who has not seen a doctor for 25 years presents to the emergency department after four episodes of vomiting over the past two days. He describes the vomitus as looking like coffee grounds.

What symptoms or history might be helpful in making the diagnosis? Consider each of the following and click on the information you believe will be most helpful for making a diagnosis.

Abdominal discomfort
Abnormal bleeding or easy bruisability
Alcohol intake
Medication use
Early satiety
Family history
Fatigue or shortness of breath
Fever
History of jaundice
History of liver disease
Have you ever used intravenous drugs?
Immunizations
Occupation
Transfusions
Travel history


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