Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Other diagnostic factors

  • light-headedness/dizziness
  • postural/orthostatic hypotension
  • dysphagia
  • odynophagia
  • pain
  • melaena
  • haematochezia
  • shock
  • signs of anaemia

Risk factors

  • condition predisposing to retching, vomiting, and/or straining
  • chronic cough
  • hiatus hernia
  • retching during endoscopy or other instrumentation
  • heavy alcohol use
  • previous instrumentation
  • age 30 to 50 years
  • male sex
  • aspirin or other NSAIDs ingestion
  • hiccups
  • blunt abdominal trauma
  • cardiopulmonary resuscitation
  • primal scream therapy

Diagnostic investigations

1st investigations to order

  • FBC
  • urea
  • liver function test
  • PT/INR
  • PTT
  • CXR
  • flexible oesophagogastroduodenoscopy
  • cross-matching/blood grouping
Full details

Investigations to consider

  • creatinine kinase
  • creatinine kinase-MB
  • troponin
  • ECG
  • angiography
Full details

Treatment algorithm

ACUTE

Contributors

Authors VIEW ALL

Juan Carlos Munoz

Associate Professor of Medicine

Gastroenterology Department

Borland-Groover Clinic

Jacksonville

FL

Disclosures

JCM declares that he has no competing interests.

Dr Juan Carlos Munoz would like to gratefully acknowledge Dr Shilpa Reddy, the previous co-contributor to this monograph. SR declares that she has no competing interests.

Peer reviewers VIEW ALL

Professor of Medicine

Department of Medicine and Therapeutics

Director

Institute of Digestive Disease

The Chinese University of Hong Kong

Hong Kong

Disclosures

JS declares that he has no competing interests.

Consultant Gastroenterologist

Sandwell General Hospital

Lyndon

West Bromwich

UK

Disclosures

IM declares that he has no competing interests.

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