The difference between hemoptysis and hematemesis, and the causes of both should be known

The difference between hemoptysis and hematemesis is the causes. The most common cause of hemoptysis is lung lesions, such as tuberculosis and lung cancer, while hematemesis is mostly caused by gastrointestinal diseases. If it is hemoptysis, timely examination should be carried out to detect the lesions as early as possible.

1. The difference between hemoptysis and hematemesis

Generally speaking, vomiting blood is usually caused by gastrointestinal diseases, which cause physical discomfort, or temporary vomiting blood caused by gastrointestinal discomfort, for example, acute gastroenteritis, or some food poisoning. In most cases, hemoptysis is caused by tracheal problems, such as chronic bronchitis, acute bronchitis, etc., which are adverse symptoms caused by respiratory diseases. The blood coughed up in this situation is generally not toxic blood, but blood that has to be discharged due to physical reasons.

2. Examination of hemoptysis

1. Hematological examination

During inflammation, the total white blood cell count often increases and there is a left shift in the nucleus. If immature white blood cells are found, the possibility of leukemia should be considered. An increase in eosinophils often indicates the possibility of parasitic disease. When there is a hemorrhagic disease, the coagulation time, prothrombin time and platelet count should be measured, and a bone marrow examination should be performed if necessary.

2. Sputum examination

Through sputum smear and culture, common pathogenic bacteria, tuberculosis bacteria, fungi, parasite eggs and tumor cells can be found.

3. Chest X-ray

Chest X-ray is of great significance for the diagnosis of hemoptysis, so it should be included in routine examination items, requiring multiple body positions, and if necessary, anterior arch position, spot film and tomographic film should be added. Curly shadows distributed along the bronchi on the chest X-ray often indicate bronchiectasis; fluid level is more common in lung abscess; solid lesions are often considered lung tumors. It is worth noting that when the lesion bleeds profusely, blood can be aspirated into the adjacent airways. This aspiration can lead to alveolar filling and form blood aspiration pneumonia, which is easily confused with solid lung lesions in the early stages. However, blood aspiration pneumonia is often absorbed within 1 week, so another X-ray will help to distinguish between the two.