Haematemesis and Melaena
Select the most likely diagnosis from the list above for
the following clinical scenarios:
1) A middle aged, obese female who has been having
pruritus for a long time presents with haematemesis and melaena. On
examination she has xanthelasma, no signs of chronic hepatocellular failure,
2) A 75-year-old male with a history of anorexia and
weight loss presents with haematemesis and melaena. On examination he looks
cachectic and on palpation of the abdomen a hard, craggy liver is felt.
3) A 24-year-old male who has been on an alcoholic binge
presents wit haematemesis following a period of prolonged vomiting. On
examination he is inebriated but there is no cardiovascular instability and
his haemoglobin is within normal limits.
4) A 50-year-old sales representative who has been
complaining of abdominal discomfort of several months’ duration .the
discomfort is relieved by meals but wakes him up form his sleep. He presents
with a 3-day history of melaena.
5) A 78-year-old male who has had a repair of an
abdominal aortic aneurysm presents with melaena, tachycardia a fall in blood
pressure and is found to be anaemic.