Prevalence
Causes
Clinical
features
Investigations
Therapy
Prevention
Prognosis
|  | | | Clinical
features |
Ask about any haematemesis or melaena before admission and its colour
c
 and amount.
d
Why?
Haematemesis and melaena make a peptic ulcer slightly more likely
| Patient |
Target Disorder and
Reference Standard |
Diagnostic Test |
LR+
(95% CI)
|
Post-test Probability |
history of haematemesis or melaena c
(pre-test probability: 51%) |
peptic ulcer
(endoscopy) |
black haematemesis and melaena |
2.4 (1.5 to 3.9) |
71% |
|
|
red haematemesis with melaena
|
1.5
(1.1 to
2.0)
|
61% |
|
|
melaena only
|
1.3
(0.88 to
1.8)
|
57% |
|
|
red haematemesis only
|
0.66
(0.48 to
0.91)
|
41% |
|
|
black haematemesis only
|
0.43
(0.30 to
0.62)
|
31% |
Red haematemesis makes varices slightly more likely
| Patient |
Target Disorder and
Reference Standard |
Diagnostic Test |
LR+
(95% CI)
|
Post-test Probability |
history of haematemesis or melaena
c
(pre-test probability: 11%)
|
varices
(endoscopy)
|
red haematemesis +/ - melaena
|
1.7
(1.4 to
2.0)
|
17% |
|
|
black haematemesis or melaena
|
0.43
(0.27 to
0.69)
|
5% |
Black haematemesis or melaena make a Mallory-Weiss tear unlikely
| Patient |
Target Disorder and
Reference Standard |
Diagnostic Test |
LR+
(95% CI)
|
Post-test Probability |
history of haematemesis or melaena
c
(pre-test probability: 3.5%)
|
Mallory-Weiss tear
(endoscopy)
|
red haematemesis +/ - melaena
|
2.1
(2.0 to
2.3)
|
7% |
|
|
black haematemesis or melaena
|
0.0
(0.0 to
0.29)
|
0% |
|
internal medicine