Haematemesis and Melaena--Part II

Complicated peptic ulceration in a child

“…The significance of the appearance or worsening of abdominal pain may not be appreciated, perhaps because these patients are expected to complain and inexperienced staff prescribe antacids or sedatives without reexamination. Conversely, reluctance to re‐open the abdomen of a recently perforated patient who has developed gastrointestinal haemorrhage is also associated with fatal results 1 .…”

“…Patients with peptic ulceration who develop gastrointestinal haemorrhage do not usually have associated abdominal pain 1 . When present, perforation as the cause of this pain is rare but may be fatal if not recognised and treated promptly 2–4 .…”