Diagnostic Dilemma

Hematemesis


Author:
Question
A 2 year old girl born of non consanguineous marriage presented with one episode of hematemesis which was fresh blood. There was no pain in abdomen, jaundice, drug ingestion, dark stools or bleeding from any other site. On examination, both general and systemic examination was normal. Investigations showed:
• Normal blood counts, prothrombin time and partial thromboplastin time
• Liver function tests = Normal
• USG Abdomen with colour doppler = Normal
• Oesophageogastroscopy = Normal

What is the cause of hematemesis_?
Expert Opinion :
Thanks to all viewers for sending their valuable comments.
Regarding swallowed blood, the child had no bleeding in the oral cavity when we examined her.
Since the blood vomited was painless, we did not consider Mallory Weiss syndrome.
Also for fundal varices there was no evidence of portal hypertension.
Patient was discharged and advised CT angiography of the abdominal vessels if she had a repeat episode of hematemsis.
Answer Discussion :
A
Akrem Atrushi
bubble
swallowed fresh blood
15 years ago
A
akila devic
bubble
swallowed blood
15 years ago

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