Haematemesis is vomiting blood. The source is generally from the upper Gastrointestinal tract.

Causes

• Vigorous and prolong retching.
• Erosion and irritation of the lining of the oesophagus or stomach.
• Bleeding ulcers located in the stomach, duodenum or oesophagus.
• Vomiting of ingested food after haemorrhage in the nose, oral cavity or throat.
• Vascular malfunctions of the GIT, such as bleeding gastrointestinal varixs.
• Tumours of stomach or oesophagus.
• Radiation poisoning.
• Viral haemorrhagic fevers.
•  Gastroenteritis.
• Gastritis.
• Peptic ulcer.
• Chronic viral hepatitis.
• Intestinal schistosomiasis(caused by the parasite Schistosoma mansoni.
• History of smoking.

  

Management 

• Haematemesis is treated as medical surgery.
• For minimal blood loss, the patient is generally administered a proton pump inhibitor(e.g. omeprazole), given blood transfusion (if the level of haemoglobin is extremely low, i.e. <8 g/dL or 4.5-5 mmol/L) and kept NPO(‘nothing by mouth’, or not eating or drinking) until endoscopy is arranged.

• Insignificant blood loss, case of haematemesis, i.e. hypovolemic shock, resuscitation is an immediate priority to prevent cardiac arrest.
• Fluids and/or blood are administered, preferably by central venous catheter, and the patient is prepared for emergency endoscopy, and laparotomy is necessary.
• Securing the airways is a top priority in haematemesis patients, especially those with a disturbed conscious level. A cuffed endotracheal tube could be a life-saving choice.