Hematemesis - Causes and Risk Factors:Any bleeding from the upper gastrointestinal tract (GI tract) like esophagus, stomach, or intestine can lead to hematemesis.
- Bleeding peptic ulcer is the most common cause of hematemesis.
- Disorders of the blood vessels of the gastrointestinal system.
- Swallowing of coughed up blood or even a nosebleed may be another factor causing hematemesis.
- Pancreatic ulcer.
- Dieulafoy's lesion: This is caused by a large stomach arteriole (a small blood vessel that branches out from an artery leading to the smaller capillaries in the blood circulation) that erodes and bleeds. This can lead to a bleed in the stomach but is an uncommon condition.
- Cancer of the esophagus, stomach or upper intestine (benign and malignant).
- Acute liver failure and alcoholic hepatitis can lead to hematemesis.
- Cirrhosis of liver, a chronic condition which causes scarring of the liver cells.
- Stomach problems like gastritis (inflammation of the stomach) or gastric erosion (defects in the inner lining of the stomach).
- Esophageal disorders like esophageal varices (enlarged blood vessels around the esophagus) and esophagitis (inflammation of the esophagus).
- Portal hypertension - a condition characterized by high blood pressure in the portal blood vessels supplying the liver.
- Excessive use of NSAID's (nonsteroidal anti-inflammatory drugs).
- Basic metabolic profile (BMP): The BMP is useful to evaluate for renal comorbidity; however, blood in the upper intestine can elevate the blood urea nitrogen (BUN) level as well.
- Measurement of coagulation parameters: This is necessary to assess for continued bleeding. Abnormalities should be corrected rapidly. Prothrombin time/activated partial thromboplastin time.
- Liver profile: The liver profile can identify hepatic comorbidity and suggest underlying liver disease.
- Calcium level: A calcium level is useful to identify the patient with hyperparathyroidism as well as to monitor calcium in patients receiving multiple transfusions of citrated blood.
- Gastrin level: A gastrin level can identify the rare patient with gastrinoma as the cause of UGIB and multiple ulcers.
- Barium contrast studies are not usually helpful and can make endoscopic procedures more difficult (i.e., white barium obscuring the view) and dangerous (i.e., risk of aspiration).
- CT scan and ultrasonography may be indicated to evaluate liver disease with cirrhosis, cholecystitis with hemorrhage, pancreatitis with pseudocyst and hemorrhage, aortoenteric fistula, and other unusual causes of upper gastrointestinal hemorrhage.
- Nuclear medicine scans may be useful to determine the area of active hemorrhage.
- An ECG should be ordered to exclude arrhythmia and cardiac disease, especially acute myocardial infarction due to hypotension.
- Performing a troponin test may be useful to identify patients with severe coronary ischemia or atypical myocardial infarction.
A new study from the University of Iowa in Iowa City, US, finds that light and frequent physical exercise can boost mental health in short- and long-term perspective. During the study, a bunch of volunteers agreed to undergo functional MRI scanning which measured...
Recent research from the Washington University School of Medicine in St. Louise, US, suggests that pregnant women who eat a diet high in fat and sugar during pregnancy increase their child’s risk of having heart issues in the future. For their study, the researchers...
In childhood, many of us dreamed of learning to jump high. Now, after years, it became easier - Kangoo Jumps has appeared. This is one of the relatively new, but quickly gaining popularity types of fitness training. There are several advantages of jumpers. ...read more
It is time for us to find the solution how to deal with extra weight which is coming with Christmas and New Year’s celebrations because 2018 is almost over and 2019 is getting closer. The main aim is obviously staying in shape and today will find an effective way to...read more
We know that moderate exercise strengthens our health and makes us more beautiful. But few know about the importance of doing sports as psychotherapy. And, nevertheless, physical loads can save from depressions, reduce anxiety, relieve from professional burnout,...read more