| |
This
website was appraised in July 2004 by C-H-i-Q the Centre for Health
Information Quality ‘Working to maximise public confidence in health
information’.
|
|
|
|
Haematemesis
Definition
Haematemesis is the vomiting of fresh or altered blood.
Incidence/Age/Sex
Incidence 150 per 100,000 population per year.
It can occur at any age, and men are affected equally with women.
Causes/Prevention
Gastric and duodenal ulcers account for 25% and 20% of haematemesis respectively.
Erosions of the stomach account for a further 20% and varicose veins of the oesophagus
which can occur in cirrhosis accounts for a further 10%. Other causes are a Mallory-Weiss
tear which occur in the lower end of the oesophagus; oesophagitis; stomach cancer
and various blood clotting problems. Aspirin or other non-steroidal anti-inflammatory
drugs increases the likelihood of haematemesis and about 3 per 1,000 patients
taking these drugs are admitted with bleeding from the stomach or duodenum.
Underlying liver disease can cause haematemesis.
Signs and Symptoms
The main symptom is the vomiting of fresh blood or altered blood which has the
appearance of coffee grounds. If there is a large amount of blood lost then the
blood pressure may be low and the heart rate may increase. Previous indigestion
is common but not invariable.
Complications of the Disorder
Serious blood loss requiring blood transfusion, anaemia and occasionally death.
Below the age of 60 mortality from this condition is small, but above the age
of 80 the mortality is greater than 20%.
Tests
Blood pressure is usually measured and a blood test taken to check the level of
haemoglobin and to look for anaemia. Intravenous fluids are usually given and
some times a blood transfusion is necessary.
Gastroscopy is performed to
look for the site of bleeding. If an ulcer is seen which is actively bleeding
it may be injected with Adrenaline or a compound to cause the bleeding vessel
to clot.
Treatment
Injection of the bleeding site as above. Blood transfusion may be required and
acid reducing therapy with a proton pump inhibitor. Surgery is required if the
bleeding is very active and if the bleeding does not stop despite the above
measures. Surgery is usually undertaken earlier in the elderly patient as older
patients are unable to tolerate blood loss as well as younger patients. The
operation may be that of oversewing the ulcer or it may be necessary to remove
part or occasionally all of the stomach.
|
|
|
Sat, Jul 31, 2010
 |
 |
 |
 |
 |
 |
We
have been selected for inclusion into OMNI,
the UK gateway to quality medical information on
the web
|
|
