Causes of vomiting blood

Hematemesis is vomiting mixed with blood or all blood. There are many reasons for hematemesis, but hematemesis is generally caused by acute bleeding in the upper gastrointestinal tract, including the stomach, duodenum, esophagus and other organs. It sounds scary. If you encounter it, many friends will become even more panicked, not knowing what to do. Let us understand the related matters of hematemesis.

Some friends often vomit blood in the morning, and they think that there is not much blood, so they don’t care much. This is wrong. If there is vomiting blood, there must be some problem. Treatment should not be delayed to avoid severe bleeding in the future, which will be more difficult to cure. If the vomiting blood is serious, you must seek medical attention immediately to find out the cause of the vomiting blood. You must go to a regular hospital for relevant treatment. The following introduces the causes and clinical manifestations of vomiting blood.

Causes

1. False hematemesis and blood in the stool occur in the following situations:

(1) Swallowing maternal blood: During childbirth, the baby swallows the dirty blood from the mother's birth canal or inhales breast milk and bleeds from the head. The Apt test can be performed to distinguish the maternal blood from the newborn's own blood.

(2) Oral and nasal injury and bleeding that is swallowed into the digestive tract.

2. Neonatal hemorrhagic disease Neonatal hemorrhagic disease is caused by vitamin K deficiency. Vomiting blood and bloody stools usually occur 2 to 3 days after birth. In severe cases, bleeding in other parts of the body may occur. Late-onset vitamin K deficiency may also cause vomiting blood and bloody stools.

3. Other less common systemic hemorrhagic diseases such as DIC, neonatal thrombocytopenic purpura and various congenital deficiencies.

4. Digestive tract diseases:

Newborn vomiting blood and blood in stool

(1) Reflux esophagitis: Clinical manifestations include persistent vomiting, hematemesis or bloody stools.

Newborn vomiting blood and blood in stool

It is often accompanied by malnutrition and growth retardation.

(2) Stress ulcers: Hypoxia, intracranial hypertension, and severe infection can cause stress ulcers and gastrointestinal bleeding.

(3) Acute gastroenteritis: Acute gastrointestinal inflammation caused by most pathogens, in addition to symptoms such as fever, vomiting and diarrhea, severe cases may also cause blood in the stool and vomiting.

(4) Intestinal obstruction: Clinical manifestations include vomiting, abdominal distension, hematemesis or bloody stool.

(5) Diseases of the sigmoid colon, rectum and anus: mostly polyps, anorectal fistulas and anal fissures causing bloody stools.

Clinical manifestations

1. False hematemesis and/or blood in the stool

(1) Swallowing maternal blood: Oral administration of iron supplements, bismuth preparations, phenolphthalein or Chinese herbal medicines to newborns may cause pseudo-gastrointestinal bleeding, but this is rare. It is common for newborns to swallow dirty blood from the mother's birth canal during delivery, or inhale maternal blood from cracked and eroded nipples, causing pseudo-hemiemesis and/or bloody stools. The child was in general good condition, with no signs of anemia or hemorrhagic shock. The anti-alkali test of hemoglobin (Apt test) confirmed that the blood was maternal blood.

(2) Swallowing one's own blood: Newborns may also suffer from vomiting blood and/or bloody stools due to swallowing their own blood in the nasopharynx or airway, which needs to be differentiated from true gastrointestinal bleeding. Usually, it is caused by a history of trauma such as intubation and local injury and bleeding. There is black tarry stool, and there is red occult blood in the wet area of ​​the diaper at the edge of the stool (if it is not wet, add clean water), or the red blood cells under the microscope may be positive.

2. Systemic bleeding and coagulation diseases have manifestations of extra-gastrointestinal bleeding, such as bleeding spots and ecchymoses on the skin and subcutaneous tissues, and abnormal changes in bleeding and coagulation examinations. Among them, DIC in critically ill children is the most common. The clinical manifestations of DIC children include severe infection, scleredema or RDS. Congenital alloimmune or passive immune thrombocytopenic purpura or various congenital coagulation factor deficiencies are less common, and often have a positive family history and corresponding bleeding and coagulation abnormalities. In the neonatal period, the most common such disease is hemorrhagic disease of the newborn. Neonatal hemorrhagic disease usually occurs 2 to 6 days after birth when vomiting blood and the amount of bleeding is large. The vomitus is mostly fresh blood and is not mixed with other components. When the amount of early bleeding is small and there is no bleeding in important organs

Newborn vomiting blood and blood in stool

, the child is generally in good condition. Delayed vitamin K deficiency is common in newborns who receive long-term antibiotic parenteral nutrition or infants who are breastfed due to mothers' picky eating habits. If bleeding is found, vitamin K15-10 mg should be injected intravenously or intramuscularly, and fresh whole blood or frozen plasma should be transfused to stop the bleeding.

3. Gastrointestinal bleeding diseases

(1) Reflux esophagitis: Symptoms include vomiting, hematemesis, slowed weight gain, etc., or there may be no symptoms at all. Endoscopic examination and dilute barium meal examination can reveal superficial lesions, and a pH value that is consistently below 5.0 is of diagnostic value. Local hemostasis can be achieved by electrocautery.

(2) Stress ulcers: Stress gastric ulcers in newborns are often caused by hypersecretion of gastric acid, which may last until the 10th day after birth, especially in the first 2 to 4 days. Increased intracranial pressure can also cause stress ulcers. It often occurs in the early stages of neonatal life with symptoms such as vomiting blood and bloody stools. The amount and age of the blood vary, and it can be cured by conservative medical treatment. Ulcers may also occur simultaneously in the esophagus or duodenum.

(3) Acute gastroenteritis: There may be vomiting of blood and/or bloody stools, especially in premature infants with necrotizing enterocolitis (NEC). In more serious cases, the affected infants have common symptoms of acute gastroenteritis, such as fever, weakness, vomiting, and diarrhea. The stool is mucus and bloody, with fresh blood, jam or black stool; vomiting of fresh blood or coffee-like brown-black blood often contains bile or intestinal contents, milk or even soy powder. Allergic enteritis caused by this condition may also cause vomiting blood and (or) bloody stool, but it is less common. Relief can be achieved by stopping this protein-rich food.

(4) Intestinal obstruction: The main cause of lower gastrointestinal bleeding in neonates is intestinal obstruction, including paralytic and/or mechanical intestinal obstruction caused by various internal and external diseases, but it is mainly caused by internal medical diseases. The child's nutrition and development were poor, and severe vomiting caused gastrointestinal bleeding.

(5) Diseases of the anus, rectum, and sigmoid colon: stools are often bloody rather than black, tarry. Most of them are caused by severe constipation, polyps, and anorectal fissures.

Newborn vomiting blood and blood in stool

4. Systemic symptoms In addition to the above-mentioned manifestations such as vomiting blood and bloody stools, a series of systemic symptoms may also be caused by massive blood loss. When the amount of blood loss exceeds 1/5 of the total blood volume, hemorrhagic anemia and (or) hemorrhagic shock may occur. Clinical symptoms include increased heart rate, cyanosis and coldness of the extremities, decreased blood pressure, blurred vision of the skin, alternating mental fatigue and irritability, etc.

Complications: A series of systemic symptoms caused by massive blood loss. When the amount of blood loss exceeds 1/5 of the total blood volume, hemorrhagic anemia and/or hemorrhagic shock may occur. Children with acute hemorrhagic shock have not yet shown signs of vomiting blood or bloody stools, but have already shown general weakness, weak crying, pale skin and mucous membranes, rapid heart rate with weak heart sounds, low blood pressure and signs of shock. If causes such as infection and poisoning, central nervous system damage, respiratory distress and heart failure have been ruled out, acute hemorrhagic shock should be considered and gastrointestinal blood loss should be observed.

Everyone has a basic understanding of the causes of vomiting blood, so everyone must distinguish that vomiting blood and coughing up blood are different. When seeking medical treatment, you must also describe your symptoms clearly so that the doctor can make a correct diagnosis, which is conducive to the treatment and recovery of the disease.