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Massive Hematemesis in Alcoholic
A 52-year-old chronic alcoholic presents with repeated bright red vomiting. He has black stools, abdominal distension, hepatomegaly, and spider angiomas. He appears restless and pale.
VITALS: BP 90/60, HR 120
Which drug should be started immediately?
Clinical Pearl:
Massive upper GI bleed in liver disease suggests variceal hemorrhage. Octreotide reduces portal venous pressure, decreases bleeding, and is started early. PPIs help ulcers but do not address varices. Vitamin K corrects coagulopathy but doesn’t stop active bleeding. Endoscopic banding follows stabilization.
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