Author: Molly Stewart / Editor: Sarah Edwards / Codes: GP6, RP3, SLO1, SLO2 / Published: 10/04/2025
A 24-year-old male presents following one episode of haematemesis. He has no past medical history but does drink ten cans of lager per day. He doesn’t report any abdominal pain, melaena or recent NSAID use.
Observations are as follows:
- Heart Rate 94 beats per minute – good radial volume
- Blood Pressure 136/72
- Respiratory Rate 18
- Oxygen saturations on room air 97%
- Temperature 36.6
On examination he looks pale and anxious. There is no melaena on PR examination and he has no abdominal tenderness.
Bloods, including full blood count and urea and electrolytes, are normal apart from a lactate of 4.1.
He has multiple episodes of witnessed haematemesis in the department and is referred to gastroenterology. He has ongoing haematemesis whilst awaiting gastroenterology and one episode of frank red blood seen mixed with clear sputum just prior to a vomiting episode. A chest x-ray is performed due to left midzone crepitations and wheeze heard on auscultation.
