Question

A 64-year-old man with a history of cirrhosis presents with large-volume haematemesis and melaena. He is hypotensive and tachycardic. After initial ABCDE resuscitation and intravenous fluid boluses, what is the most appropriate next step in his management?

Accepted Answer

Urgent upper GI endoscopy after stabilisation with blood transfusion as needed

Answer

Arrange urgent colonoscopy

Answer

Start high-dose oral proton pump inhibitor and discharge for outpatient endoscopy

Answer

Perform CT abdomen with contrast to look for bleeding source

Answer

Manage conservatively and observe without further investigation

Practice question

A 64-year-old man with a history of cirrhosis presents with large-volume haematemesis and melaena. He is hypotensive and tachycardic. After initial ABCDE resuscitation and intravenous fluid boluses, what is the most appropriate next step in his management?