Gastrointestinal Bleed
The Case:
The Ada County Coroner’s office was notified by a local hospital that a patient had come to the ER and had expired within 24 hours. The Deputy on duty responded to the hospital and was told that the subject had been transferred to the ICU and to go to unit for additional information and medical records.
The subject’s medical history included several bouts with Hematemesis. He had previously been diagnosed with End Stage Liver Disease from Hepatitis. He also had a history of another massive GI bleed from the Esophageal Varices. Noted in the history was his known abuse of IV drugs, starting at age 18.
The body was transported to the Ada County Coroner’s office for additional inspection by the Forensic Pathologist on duty. The Forensic Pathologist signed the death certificate with cause of death being Gastrointestinal Bleed due to Esophageal Varices. The manner of death was natural.
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What is Hematemesis? Hematemesis is the vomiting of blood. The bleeding is usually from the upper gastrointestinal (GI) tract. This means the bleeding may be from the esophagus (the tube that connects the mouth and stomach), the stomach, or the upper small intestine (duodenum).
How does it occur?
The most common cause of upper GI bleeding is an ulcer in the stomach or small intestine. Irritation of the stomach (gastritis) or esophagus (esophagitis) can also cause bloody vomit. Medicines such as aspirin, ibuprofen, and naproxen are common causes of stomach and esophagus irritation.
Another common cause of bleeding is liver disease. When the liver has scars from cirrhosis, the veins around the esophagus become swollen, like varicose veins of the legs. The veins may tear and bleed suddenly after you cough or vomit, or they may bleed for no apparent reason.
Sometimes the esophagus bleeds because it is torn. These tears may happen after forceful coughing or vomiting, especially, for example, after a severe bout of stomach flu or from vomiting after drinking too much alcohol.
It is unusual for cancers of the stomach and esophagus to cause large amounts of bloody vomit.
What are the symptoms?
Vomiting blood can be a symptom. In mild cases, you may notice small amounts of bright, red blood in your vomit. Or you may see dark brown or black material that looks like coffee grounds. This is blood digested by stomach acids. If the bleeding is severe, you may keep vomiting large amounts of bright red blood.
You may have other symptoms, depending on the cause of the vomiting of blood. These symptoms may be:
- heartburn
- stomach pain
- dark, black, tarry bowel movements.
Black, tarry stools may mean that you have had bleeding from your stomach or intestines for some time. Blood that passes through the intestines is digested and turns black.
How can I help prevent GI bleeding?
Prompt treatment of the frequent causes of vomiting blood may prevent it from ever occurring. See your healthcare provider promptly if you have:
- symptoms of ulcers or irritation of the stomach or esophagus, such as stomach pain, heartburn, or acid indigestion
- black, tarry bowel movements.
If you drink too much alcohol, you are at high risk of developing scarring of the liver (cirrhosis) and problems with your esophagus and stomach that may cause sudden, severe bleeding.
Gastrointestinal Bleed
The Case:
The Ada County Coroner’s office was notified by a local hospital that a patient had come to the ER and had expired within 24 hours. The Deputy on duty responded to the hospital and was told that the subject had been transferred to the ICU and to go to unit for additional information and medical records.
The subject’s medical history included several bouts with Hematemesis. He had previously been diagnosed with End Stage Liver Disease from Hepatitis. He also had a history of another massive GI bleed from the Esophageal Varices. Noted in the history was his known abuse of IV drugs, starting at age 18.
The body was transported to the Ada County Coroner’s office for additional inspection by the Forensic Pathologist on duty. The Forensic Pathologist signed the death certificate with cause of death being Gastrointestinal Bleed due to Esophageal Varices. The manner of death was natural.
_______________________________________________________________________________
What is Hematemesis?
Hematemesis is the vomiting of blood. The bleeding is usually from the upper gastrointestinal (GI) tract. This means the bleeding may be from the esophagus (the tube that connects the mouth and stomach), the stomach, or the upper small intestine (duodenum).
How does it occur?
The most common cause of upper GI bleeding is an ulcer in the stomach or small intestine. Irritation of the stomach (gastritis) or esophagus (esophagitis) can also cause bloody vomit. Medicines such as aspirin, ibuprofen, and naproxen are common causes of stomach and esophagus irritation.
Another common cause of bleeding is liver disease. When the liver has scars from cirrhosis, the veins around the esophagus become swollen, like varicose veins of the legs. The veins may tear and bleed suddenly after you cough or vomit, or they may bleed for no apparent reason.
Sometimes the esophagus bleeds because it is torn. These tears may happen after forceful coughing or vomiting, especially, for example, after a severe bout of stomach flu or from vomiting after drinking too much alcohol.
It is unusual for cancers of the stomach and esophagus to cause large amounts of bloody vomit.
What are the symptoms?
Vomiting blood can be a symptom. In mild cases, you may notice small amounts of bright, red blood in your vomit. Or you may see dark brown or black material that looks like coffee grounds. This is blood digested by stomach acids. If the bleeding is severe, you may keep vomiting large amounts of bright red blood.
You may have other symptoms, depending on the cause of the vomiting of blood. These symptoms may be:
- heartburn
- stomach pain
- dark, black, tarry bowel movements.
Black, tarry stools may mean that you have had bleeding from your stomach or intestines for some time. Blood that passes through the intestines is digested and turns black.
How can I help prevent GI bleeding?
Prompt treatment of the frequent causes of vomiting blood may prevent it from ever occurring. See your healthcare provider promptly if you have:
- symptoms of ulcers or irritation of the stomach or esophagus, such as stomach pain, heartburn, or acid indigestion
- black, tarry bowel movements.
If you drink too much alcohol, you are at high risk of developing scarring of the liver (cirrhosis) and problems with your esophagus and stomach that may cause sudden, severe bleeding.