A 55-year-old male with known liver cirrhosis presents with massive haematemesis. He is tachycardic at 140 bpm, hypotensive at 70/40 mmHg, and confuse...

Question

A 55-year-old male with known liver cirrhosis presents with massive haematemesis. He is tachycardic at 140 bpm, hypotensive at 70/40 mmHg, and confused. What is the most likely cause of the upper GI haemorrhage and what specific pre-hospital interventions are appropriate?

Accepted Answer

Oesophageal variceal haemorrhage - IV access, permissive hypotension, TXA 1 g IV, and urgent transfer to a centre with endoscopy and interventional capability

Answer

Peptic ulcer bleeding - administer IV omeprazole 40 mg

Answer

Aorto-enteric fistula - immediate surgical referral only

Answer

Mallory-Weiss tear - apply abdominal compression

Answer

Gastric carcinoma bleeding - no pre-hospital treatment possible

uk-dipimc MCQ (SBA): Variceal Haemorrhage

A 55-year-old male with known liver cirrhosis presents with massive haematemesis. He is tachycardic at 140 bpm, hypotensive at 70/40 mmHg, and confused. What is the most likely cause of the upper GI haemorrhage and what specific pre-hospital interventions are appropriate?