Emergency Medicine Case Study: Upper GI Bleed

What was the primary reason for the urgent endoscopy performed on the patient?

What does a heart rate of 124 beats per minute indicate about the patient's condition?

What is the significance of the patient's blood pressure reading of 82/58 mmHg?

What finding was observed during the endoscopy of the patient's duodenum?

What does a respiratory rate of 26 breaths per minute indicate in this patient?

Patient Presentation

54-year-old male with profuse haematemesis (vomiting of blood).
Vital signs indicate significant instability:
- Temperature: 36.9ºC (normal).
- Oxygen saturation: 94% on air (possible hypoxia).
- Heart rate: 124 beats per minute (tachycardia).
- Respiratory rate: 26 breaths per minute (tachypnea).
- Blood pressure: 82/58 mmHg (indicating hypotension and potential shock).

Clinical Action

Urgent endoscopy performed to achieve haemostasis (control bleeding).
Identified a duodenal ulcer on the posterior wall during endoscopy, a common source of gastrointestinal bleeding.

Potential Complications

Haematemesis suggests possible upper gastrointestinal bleeding, which can lead to significant blood loss and shock.
Ulcer location on the posterior wall of the duodenum can be associated with higher risk of complications such as penetration into neighboring organs or major vessels.

Considerations

Immediate management prioritized due to signs of hemodynamic instability.
Management may involve fluids, blood transfusions, and addressing the underlying cause of the ulcer (e.g., H. pylori, NSAID use).

This quiz discusses a clinical case of a 54-year-old man presenting with profuse haematemesis and signs of shock. The scenario highlights the importance of urgent endoscopy in managing gastrointestinal emergencies, focusing on a duodenal ulcer identified during the procedure. Test your knowledge on emergency responses and gastrointestinal disorders.