Clinical Case Database / Category: Clinical Care

Management of upper GI haemorrhage-variceal bleeding

Publication details

Dr Edward J. Despott, Dr Rajiv Jalan
Foundation Years Journal, volume 1, issue 3, p.111 (123Doc Education, London, June 2007)


A 47-year-old property manager presents to A&E with a 6-hour history of large volume fresh haematemesis associated with a feeling of light-headedness. He gives a history of significant alcohol consumption of 60 units per week for the last 15 years. There is no other past medical history of note. The patient is on no regular medication and has no known allergies. Clinical examination reveals a tachycardia of 120 bpm and a blood pressure of 90/60mmHg (with a postural drop of 25mmHg). The patient is pale and jaundiced and has numerous stigmata of chronic liver disease including numerous spider naevi and Dupuytren’s contractures bilaterally. There is abdominal distension with flank dullness, in keeping with ascites and rectal examination confirms the presence of melaena.

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Dr Edward J. Despott

Specialist Registrar Gastroenterology/Hepatology
UCLH London

Dr Rajiv Jalan

Senior Lecturer and Consultant Hepatologist


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7.  Uriz J. et al Terlipressin plus albumin infusion: an effective and safe therapy of hepatorenal syndrome. J Hepatol 2000; 33: 43-48.


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T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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