Vomiting of Blood (Hematemesis): Symptoms, Complaints, Signs

The following symptoms and complaints may indicate hematemesis (vomiting blood):

Leading symptoms

• Vomiting of coffee-ground-like or red blood.
• The coffee grounds-like appearance comes from prolonged retention of the blood in the stomach

Note

• A patient with hematemesis is considered a medical emergency, i.e. immediate hospitalization required!

Warning signs (red flags)

• Enlarged supraclavicular lymph nodes → think: malignant neoplasm:
  • Gastric carcinoma/stomach cancer (Virchow lymph node involvement; supraclavicular left; absolute rarity).
  • Bronchial carcinoma/lung cancer (hemoptysis; approximately 30% cases of all patients with bronchial carcinoma).
• Tachycardia (heartbeat too fast: > 100 beats per minute) → think of: significant upper gastrointestinal bleeding (GI bleeding, GIB); immediate hospitalization.
• At the slightest suspicion of esophageal varices (e.g., hematemesis and vomiting of coffee-ground-like gastric contents; hematochezia (black stools); skin pallor; tachycardia; collapse; circulatory shock) → hospitalization should be made by ambulance and venous access placed