Haematemesis is the vomiting of blood. This may be frank blood or blood altered by the action of gastric acid and digestive enzymes, i.e. ‘coffee grounds’. Haematemesis is usually caused by lesions proximal to the duodenojejunal junction. Check for a recent history of epistaxis or haemoptysis. There may be a history of excess alcohol consumption or a history of other liver disease to suggest oesophageal varices. A history of retrosternal burning pain and heartburn would suggest oesophagitis. The bleeding associated with varices is often torrential; that associated with oesophagitis is minor. Check for a history of dysphagia, which can result from carcinoma.
Haematemesis
History
Swallowed blood
Oesophagus
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