An Unusual Case of Acute Upper Gastrointestinal Bleeding

Question: A 45-year-old man presented to the Emergency Department with hematemesis for 3 hours. Physical examination revealed an anemic appearance and abdominal tenderness. The patient had a past medical history of hemoptysis 20 days earlier, at which time the result of a purified protein derivative test and bronchoalveolar lavage did not support tuberculosis. On this admission, the vital signs of the patient indicated unstable hemodynamics (blood pressure 82/53 mm Hg). Laboratory routine blood tests showed a hemoglobin level of 8.7 g/dL.