What are the key differential diagnoses to consider in a patient with haematemesis?

When a patient presents with haematemesis, key differential diagnoses to consider primarily include conditions causing upper gastrointestinal bleeding ³.

• Oesophageal or stomach cancer is a significant differential diagnosis for haematemesis ¹. For this, a non-urgent, direct access upper gastrointestinal endoscopy should be considered ¹.
• Upper gastrointestinal bleed in general is indicated by haematemesis ³.
• In some cases, particularly in infants, ingested blood from sources like a nosebleed or a cracked maternal nipple should be ruled out as a cause of blood-stained vomit ³.
• Peptic ulcer disease is also a strong risk factor for subsequent upper gastrointestinal bleeding, which can manifest as haematemesis ⁶.