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Acute variceal hemorrhage — RCPSC IM MCQ

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HardGastroenterology/HepatologyAcute variceal hemorrhageRCPSC IM

A 58-year-old man with alcohol-related cirrhosis presents with hematemesis and melena. Blood pressure is 92/54 mmHg, pulse is 122/min, hemoglobin is 71 g/L, INR is 1.8 and platelets are 58 x 10^9/L. He is confused and has ascites. After airway assessment and resuscitation are started, the endoscopy team is available within 6 hours. What is the most appropriate investigation?

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Correct answer: C — Urgent upper endoscopy after initial resuscitation

Suspected variceal upper GI bleeding requires urgent upper endoscopy after stabilisation, while antibiotics and vasoactive therapy are started.

Reference: Canadian Association of Gastroenterology cirrhosis/variceal bleeding resources