Clinical diagnosis is largely based on the patient’s history, however investigations are useful to risk assess and guide management.


  • Venous Blood gas can help to assess haemoglobin level quickly but do not rely solely on this – there is a lag period between blood loss and Hb drop!
  • Urea and electrolytes (urea will be raised after a significant volume bleed)
  • Full blood count
  • Coagulation screen (derangement of clotting in liver diseases)
  • Liver function tests (identifying liver disease)
  • Cross match (type specific or full cross match depending on urgency)
  • Chest x-ray, 12-lead ECG
  • Little role for abdominal x-ray- CT abdomen may be of more benefit if concern about diverticular bleed, or small bowel obstruction
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