Gastroenterology — ESEGH MCQ

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HardGBS 0-1) may be discharged with outpatient care rather than admitted. Routine octreotide or surgery is unnecessary without variceal suspicion or instability."GastroenterologyESEGH

A 40-year-old presents with melaena, normal observations, normal haemoglobin and urea, no syncope, comorbidity or hepatic disease, and a Glasgow-Blatchford score of 0. What is the most appropriate disposition?

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Correct answer: E — Early discharge with outpatient follow-up

NICE recommends considering early discharge for patients with a pre-endoscopy Glasgow-Blatchford score of 0. This is a validated very-low-risk group. Safe discharge still requires an appropriate outpatient plan and clear advice to return if bleeding, syncope or deterioration occurs. Vasoactive therapy is for suspected variceal bleeding, while transfusion and urgent intervention are not indicated by this presentation.

Reference: NICE CG141: Acute upper gastrointestinal bleeding. https://www.nice.org.uk/guidance/cg141/chapter/Recommendations