GI Emergencies: A Quick Reference Guide

Robert C. Lowe, MD; Francis A. Farraye, MD, MSc

Chapter 2: Evaluation And Management Of Acute Variceal Hemorrhage (continued)

Ashraf Saleemuddin, MD; Uri Avissar, MD

You receive the following call from the emergency department (ED): A 57-year-old woman with primary biliary cirrhosis (PBC) presents with malaise and dizziness following an episode of hematemesis earlier in the day. She was diagnosed with PBC 9 years ago after evaluation for fatigue and an elevated alkaline phosphatase level. At the time, a liver biopsy demonstrated cirrhosis. She currently has adequate liver synthetic function and shows no evidence of liver decompensation. Her last endoscopy was about 2 years prior and was notable for small esophageal varices. Today, she felt nauseated an…