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Non-variceal upper gastrointestinal bleeding — ESEGH MCQ

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ModerateGI BleedingNon-variceal upper gastrointestinal bleedingESEGH

A 68-year-old man presents with melaena after taking naproxen. Blood pressure is 118/72 mmHg, pulse 94/min and haemoglobin is 104 g/L. Urea is 14 mmol/L. He has no syncope or liver disease. Glasgow-Blatchford score is 8. What is the most appropriate management?

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Correct answer: E — Admit for endoscopy within 24 hours after resuscitation and risk assessment

A Glasgow-Blatchford score above low-risk thresholds supports admission and inpatient endoscopy for upper GI bleeding. Discharge is reserved for very low-risk patients. Terlipressin alone is not appropriate without suspected variceal bleeding and does not replace endoscopy. The pearl is that early risk scoring standardises urgency and site of care.

Reference: NICE CG141