Acute upper gastrointestinal bleeding

Acute upper gastrointestinal bleeding

Causes
Peptic ulcer ~40%.
Mallory Weiss tear 15%.
Gastroduodenal erosions ~10%.
Oesophagitis ~10%.
Varices ~7%.

Other: malignancy, vascular malformations, haemoptysis (swallowed blood).

Signs & symptoms
Haematemesis, or melaena, dizziness (especially postural),
fainting, abdominal pain, dysphagia?
Postural hypotension, hypotension, tachycardia (not if on B-blocker),
increase JVP, increase urine output,
cool and clammy, signs of chronic liver disease;
telangiectasia or purpura;
jaundice (biliary colic + jaundice + melaena suggests haemobilia).
NB: ask about previous GI problems, drug use, and alcohol intake.