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Hematemesis is the vomiting of blood. [1] This is usually vomit that contains bright red blood. [2] Coffee ground vomiting is similar to hematemesis, but is distinct in not involving bright red blood. [3] Hematemesis must be differentiated from hemoptysis (coughing up blood) and epistaxis (nosebleed). [4] Both of these are more common conditions.
Blood may be observed in vomit or in altered form as black stool. Depending on the amount of the blood loss, symptoms may include shock. Upper gastrointestinal bleeding can be caused by peptic ulcers, gastric erosions, esophageal varices, and rarer causes such as gastric cancer.
Gastrointestinal bleeding can range from small non-visible amounts, which are only detected by laboratory testing, to massive bleeding where bright red blood is passed and shock develops. Rapid bleeding may cause syncope. [18] The presence of bright red blood in stool, known as hematochezia, typically indicates lower gastrointestinal bleeding ...
The severity of hemorrhagic shock can be graded on a 1–4 scale on the physical signs. The shock index (heart rate divided by systolic blood pressure) is a stronger predictor of the impact of blood loss than heart rate and blood pressure alone. [11] This relationship has not been well established in pregnancy-related bleeding. [12]
These early symptoms can include diarrhea (which is often bloody), stomach cramps, mild fever, [10] or vomiting that results in dehydration and reduced urine. [9] HUS typically develops about 5–10 days after the first symptoms, but can take up to 3 weeks to manifest, and occurs at a time when the diarrhea is improving. [10]
[3] [2] Hypovolemic shock is a medical emergency; if left untreated, the insufficient blood flow can cause damage to organs, leading to multiple organ failure. [4] In treating hypovolemic shock, it is important to determine the cause of the underlying hypovolemia, which may be the result of bleeding or other fluid losses.
The symptoms of an episode of diabetic ketoacidosis usually evolve over a period of about 24 hours. Predominant symptoms are nausea and vomiting, pronounced thirst, excessive urine production and abdominal pain that may be severe. [13] [14] In severe DKA, breathing becomes rapid and of a deep, gasping character, called "Kussmaul breathing".
Untreated hypovolemia or excessive and rapid losses of volume may lead to hypovolemic shock. [7] Signs and symptoms of hypovolemic shock include increased heart rate, low blood pressure, pale or cold skin, and altered mental status. When these signs are seen, immediate action should be taken to restore the lost volume.