Haematemesis is a serious symptom that is caused usually by a serious disease and it is considered a medical emergency .
Vomiting of blood.
I. Oesophageal Causes:
- Rupture oesophageal varices.
- Oesophageal erosions due to GORD.
- Carcinoma of the oesophagus .
- Rupture of aortic aneurysm into the oesophagus.
II. Gastro-Duodenal Causes:
-Acute gastritis & acute gastric ulcers especially due to drugs as NSAIDs & cortisone and stress (stress ulcer).
- Chronic peptic ulcer whether gastric or duodenal.
- Hiatus hernia, if associated with GORD & oesophagitis.
- Cancer stomach & rarely cancer ampulla of Vater.
- Peutz-Jeghers syndrome: G.l. polyposis & pigmentation.
- Angiodysplasia of the stomach.
III. Small intestinal causes:
- Angiodysplasia in the small intestine .
- Small intestinal tumors as adenocarcinoma.
- Ulcers complicating prolonged use of NSAIDs.
- Familial adenomatous polyposis.
- Typhoid ulcers..
IV. General Causes:
- Haemorrhagic blood diseases.
- Haemorrhagic fevers as Rift valley fever.
- Severe hypertension.
V. False Haematemesis:
Ingestion of blood after bleeding from the nose, mouth or Pharynx then vomiting of this blood.
- Differentiation from haemoptysis .
- Differentiation from false haematemesis by local examination .
- Differentiation of the cause through:
- Good history.
- Physical examination.
- Oesophago-gastroduodenoscopy .
- Capsule endoscopy
- Barium follow-through for small intestirie.
- Liver functions & ultrasonography.
- Isotope studies & angiography.
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