A 52-year-old presents after one episode of coffee-ground vomiting. Pulse is 78/min, systolic blood pressure 128 mmHg, haemoglobin 146 g/L, urea 5.1 m...

Question

A 52-year-old presents after one episode of coffee-ground vomiting. Pulse is 78/min, systolic blood pressure 128 mmHg, haemoglobin 146 g/L, urea 5.1 mmol/L and there is no melaena, syncope, hepatic disease or heart failure. His Glasgow-Blatchford score is 0. What is the best disposition?

Accepted Answer

Consider discharge with arranged outpatient follow-up and safety-netting

Answer

Admit for inpatient endoscopy within the next twenty-four hours

Answer

Admit for intravenous proton-pump inhibitor before urgent endoscopy

Answer

Observe until a post-endoscopy Rockall score can be calculated

Answer

Request CT angiography before deciding whether admission is required

UGIB Risk Stratification — MRCEM SBA MCQ

A 52-year-old presents after one episode of coffee-ground vomiting. Pulse is 78/min, systolic blood pressure 128 mmHg, haemoglobin 146 g/L, urea 5.1 mmol/L and there is no melaena, syncope, hepatic disease or heart failure. His Glasgow-Blatchford score is 0. What is the best disposition?