Читать книгу Clinical Reasoning in Veterinary Practice - Группа авторов - Страница 69

Persistent vomiting of fresh blood or vomiting of digested blood (coffee grounds) can be of significant clinical concern. The cause may be primary GI disease or secondary GI disease. Contrary to popular belief, most patients that are vomiting do not have gastric ulceration and do not need to be treated with an anti‐ulcer drug. However, there may be a role for use of drugs that suppress gastric acid secretion (preferably proton‐pump inhibitors) to prevent secondary oesophagitis.

Haematemesis may be the only sign of gastric bleeding, but concurrent melaena is common (see Chapter 12).

Primary GI causes of haematemesis include:

 NeoplasiaLymphoma, adenocarcinoma, leiomyoma and leiomyosarcoma

 Gastric foreign body

 Severe inflammatory disease.

Secondary GI causes of haematemesis include:

 Coagulopathy

 Secondary GI diseases causing gastric ulcerationNSAIDsHepatic diseaseHypoadrenocorticismGastrinomaMast cell tumour (non‐GI location)TraumaRenal failureSystemic inflammationFor example, pancreatitis, sepsisExtreme exerciseFor example, sled dog racing.