Haematemesis

Haematemesis means vomiting blood. If the blood is a small amount and has been present in the stomach for some time then it will be altered by the gastric acid and characteristically appear as "coffee grounds". It is usually a consequence of severe gastritis or superficial ulceration. It is very rare in children, but does occur in adolescents with peptic ulcer disease (described below). Vomiting bright red blood is indicative of severe bleeding from an ulcer which has eroded an artery, or from oesophageal varices (see the oesophagus in the chest section). Occasionally haematemesis may result from a severe nosebleed when the blood has been swallowed. Bleeding into the stomach, besides causing haematemesis, also causes blood to pass down into the gut. The action of the gut enzymes turns this into a black tarry motion, called malaena, which has a characteristic odour. Haematemesis and malaena should always be investigated.
 
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