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Unstable upper gastrointestinal bleeding — RCPSC EM MCQ

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HardGI/Abdominal emergenciesUnstable upper gastrointestinal bleedingRCPSC EM

A 67-year-old man vomits a large amount of blood in the ED. Blood pressure is 84/48 mmHg, heart rate 132/min, haemoglobin is 76 g/L, INR is 2.8 on warfarin, and he has melena. After immediate resuscitation is started, What is the most appropriate investigation?

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Correct answer: A — Urgent upper endoscopy

In unstable suspected upper GI bleeding, endoscopy is the key diagnostic and therapeutic investigation once resuscitation is underway.

Reference: Canadian Association of Gastroenterology upper GI bleeding guidance