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Acute variceal haemorrhage — RACP Written MCQ

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HardGastroenterology/HepatologyAcute variceal haemorrhageRACP Written

A 59-year-old man with alcohol-related cirrhosis vomits fresh blood and is hypotensive. He has ascites and spider naevi. Haemoglobin is 78 g/L, INR 1.8 and platelets are 72 x 10^9/L. After resuscitation and initial drug therapy, What is the most appropriate investigation?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Urgent upper gastrointestinal endoscopy

Suspected variceal bleeding requires resuscitation, vasoactive therapy and antibiotics, followed by urgent upper GI endoscopy for diagnosis and therapy.

Reference: Therapeutic Guidelines: Gastrointestinal; Gastroenterological Society of Australia guidance