Approach to melena and hematemesis Quiz: Ace Your Exams
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A 61-year-old woman is seen in the emergency department for black stools and abdominal pain for four days. The patient reports the pain is worse with eating. The patient vomited a small amount of bright red blood seven days ago. She states that she had been in her usual state of health until the current symptoms developed. Past medical history is significant for cirrhosis. Six months ago, the patient underwent an upper endoscopy that did not show esophageal varices. The patient takes nadolol and naproxen twice daily for knee pain. Vital signs are within normal limits. Physical examination demonstrates moderate tenderness to palpation in the epigastrium. Serum hemoglobin is 8.9 g/dL. Which of the following is the likely etiology of this patient's condition?
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