ESOPHAGEAL

VARICEAL
BLEEDING
• Male patient age 61years old with known case of hypertension and Hepatitis C
• Presented to ER with vomitting started early that day.
• Hematemesis red in color and one small cup full(app 100ml) on same day of admission.
• Loose black stool(melena), abdominal pain, dizziness, fatigue, loss of appetite.
• PSH: retired, married(no children), live in apartment, smokes(5-6pieces/day) since age
20, drinker (30y), IVDU, no recent travel
• FH: no similar cond, no chronic illness, no malignancy running in family.
• PMH: Htn (10years-Covapril), Hepatitis C, no past surgical hx, no blood transfusion,
allergy unknown.
SYSTEMIC REVIEW

General : No fever, night sweat

CVS: No chest pain/angina, dyspnea, palpitation
Resp: No sputum, cough, wheeze, sob
Musculoskeletal: No pain/swelling/stiffness in muscle/joint/back
CNS: No, tingling, numbness, headache, loss of consciousness
GIT: No indigestion, heart burn, dysphagia, dyspepsia
CASE SUMMARY

• A 59y/o man was admitted to hospital due to hematemesis associated with loose black
stool(melena) dizziness, fatigue, abdominal pain and loss of appetite
• On physical examination the abdomen was distended. There was positive shifting
dullness.
PROVISIONAL DIAGNOSIS
DIFFERENTIAL DIAGNOSIS
INVESTIGATION

Haematological test

Liver function test

Hepatitis C screening

Hepatitis B screening

Endoscope examination