Clinical features
Haematemesis and melaena are characteristic of an upper gastrointestinal bleed.
In the history, ask the patient about:
- dyspepsia
- alcohol abuse
- ingestion of analgesics
- family history
- syncope
- dizziness
- antecedent retching
- previous episodes
- weight loss
Possible signs of an upper GI bleed include:
- tachycardia
- pallor
- sweating
- low blood pressure, postural drop
- melaena on digital rectal examination
Also look for the stigmata of liver disease.
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