Hematemesis 540173 219759423 2008-06-16T19:30:21Z 74.160.9.76 /* Causes */ added a cause of hematemesis {{Infobox_Disease | Name = Hematemesis | Image = | Caption = | DiseasesDB = 30745 | ICD10 = {{ICD10|K|92|0|k|92}} | ICD9 = {{ICD9|578.0}} | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = med | eMedicineTopic = 3565 | MeshName = Hematemesis | MeshNumber = C23.550.414.788.400 | }} '''Hematemesis''' or '''haematemesis''' (see [[American_and_British_English_spelling_differences#Simplification_of_ae_.28.C3.A6.29_and_oe_.28.C5.93.29|American and British spelling differences]]) is the [[vomiting]] of [[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. ==Signs== Signs of the onset of hematemesis may include: * A history of [[alcohol abuse|excessive alcohol use]] or [[liver disease]] * Any esophogastric symptoms, such as nausea or vomiting * Brown or black vomit * Vomit that looks like coffee grounds * Dark colored, tar like stools (a condition known as [[melena]]) ==Causes== Causes can be: * Prolonged and vigorous [[retching]] (may cause a tear in the small blood vessels of the throat or the esophagus, producing streaks of blood in the vomit, and is called [[Mallory-Weiss syndrome]]). * Irritation or erosion of the lining of the [[esophagus]] or [[stomach]] * Bleeding ulcer located in the [[stomach]], [[duodenum]], or [[esophagus]] * Ingested blood (for example, swallowed after a nosebleed) * [[Vomiting]] of ingested blood after [[hemorrhage]] in the oral cavity, nose or throat * Vascular malfunctions of the [[gastrointestinal tract]] * [[Tumor]]s of the [[stomach]] or [[esophagus]] * [[Esophagitis]] * [[Gastroenteritis]] * [[Gastritis]] * [[Mallory-Weiss syndrome]] (esophageal tear) * [[Esophageal varices]] * [[Peptic ulcer]] * [[Gastric varices]] * [[Dieulafoy's lesion]] * [[Wilson's disease]] (hepatolenticular degeneration) * [[Trichophagia]] * [[Ebola]] or [[Marburg Virus]] * [[Yellow Fever]] ==Management== Hematemesis is treated as a [[medical emergency]]. The most vital distinction is whether there is blood loss sufficient to cause [[Shock (medical)|shock]]. ===Minimal blood loss=== If this is not the case, the patient is generally administered a [[proton pump inhibitor]] (e.g. [[omeprazole]]), given [[blood transfusion]]s (if the level of [[hemoglobin]] is extremely low, that is less than 8.0 g/dL or 4.5-5.0 mmol/L), and kept [[nil per os]](nil by mouth) until [[endoscopy]] can be arranged. Adequate venous access (large-bore [[cannula]]s or 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, that is [[hypovolemic shock]], resuscitation is an immediate priority to prevent [[cardiac arrest]]. Fluids and/or blood is administered, preferably by central venous catheter, and the patient is prepared for emergency endoscopy, which is typically done in theatres. [[Surgery|Surgical]] opinion is usually sought in case the source of bleeding cannot be identified endoscopically, and [[laparotomy]] is necessary. == See also == * [[Upper gastrointestinal bleeding]] * [[Shock (medical)|Shock]] * [[Melena]] ==External links== * [http://www.umm.edu/ency/article/003118.htm] * [http://www.nlm.nih.gov/medlineplus/ency/article/003118.htm NIH/Medline] [[Category:Symptoms]] [[Category:Vomiting]] {{med-sign-stub}} {{Gastroenterology}} [[ar:قيء دموي]] [[de:Hämatemesis]] [[es:Hematemesis]] [[fr:Hématémèse]] [[ja:吐血]] [[pl:Wymioty fusowate]] [[pt:Hematemese]]