Case 41

Abstract A 28-year-old woman presented to the Emergency Department with a 1-day history of vomiting blood, following 10 days of profuse vomiting. She reported vomiting a large spoonful of bright red blood on 2 occasions over the last day. The first time was at the end of a bout of vomiting and the blood mixed with vomitus. The second time was before any further vomiting, and she described fresh, bright red blood. She reported vomiting more than 6 times each day, retching many times each day, and feeling nauseated for most of the day. She found it increasingly hard to eat and vomited after eating and drinking fluids. She had also experienced some epigastric tenderness for 2 days. She had not opened her bowels for 2 days but prior to that reported normal stool.