Approach to melena and hematemesis Quiz: Ace Your Exams

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A 51-year-old woman presents to the emergency department after an episode of hematemesis. The patient has otherwise had no recent vomiting. The patient has no abdominal pain, early satiety, or excessive belching and does not take NSAIDs. The patient has had several black tar-like stools over the past few days. Temperature is 37.3 ºC (99.1 ºF), pulse is 108/min, blood pressure is 102/71 mmHg, respiratory rate is 18/min, and SpO2 is 98% on room air. Physical examination is notable for scleral icterus, splenomegaly, and abdominal distention. Serum international normalized ratio (INR) is 1.6. Stool H. pylori antigen is negative. An upper endoscopy is scheduled. Which of the following will likely be seen on upper endoscopy?  

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