Hematemesis is the oral emission of blood with vomiting. Symptomatology and objective signs depend on etiology. In the case of massive hemorrhage, symptomatology and objectivity in hypovolemic shock will be present. Immediate procedures such as cannulation of the vein, suspension of solid and liquid feeding, and insertion of a naso-gastric tube must be performed.
Laboratory tests to be performed are CBC, azotemia, blood glucose, ionogram, endoscopy, angiography, radioactive isotope radiological investigations, ECG, PA. In the case of esophageal varices, urgent perendoscopic sclerotherapy, endoscopic hemostasis and a possible infusion of Samotostatin is essential. For hematemesis of other nature sometimes targeted surgery or random therapy is needed.
Source: Medical Emergencies in Pediatrics by Mediserve edited by Maurizio Vanelli
