Case history
Case history #1
A 48-year-old man presents to hospital after several episodes of vomiting blood following periods of forceful retching and vomiting. He has been binge drinking alcohol over the preceding 2 days.
Case history #2
A 64-year-old man presents to hospital after 4 episodes of vomiting over the past 2 days. He describes the appearance of the vomit as resembling coffee grounds. Black, tarry stool was seen during rectal examination; however, no other physical findings were seen.
Other presentations
Typically, haematemesis follows any event that provokes a sudden rise in pressure gradient across the gastro-oesophageal junction, such as retching, vomiting, coughing, or straining. Other less common symptoms include melaena; haematochezia; syncope; atypical chest pain with interscapular radiation (may indicate tear or rupture of the oesophagus); and retrosternal, epigastric, or back pain. Severe pain is rare in MWT. Rarely, MWT may present with signs of anaemia (pallor, shortness of breath, and/or dyspnoea on exertion). Massive upper gastrointestinal bleeding is an unusual presentation. However, massive haemorrhage requiring blood transfusion, and leading to death, has been described.[4][5][6][7]
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