Which of the following is the most common presenting symptom of non-cirrhotic poal hypeension?
Correct Answer: Upper gastrointestinal bleeding
Description: Clinical assessment Haematemesis is red with clots when bleeding is rapid and profuse, or black ('coffee grounds') when less severe. Syncope may occur and is caused by hypotension from intravascular volume depletion. Symptoms of anaemia suggest chronic bleeding. Melaena is the passage of black, tarry stools containing altered blood; it is usually caused by bleeding from the upper gastrointestinal tract, although haemorrhage from the right side of the colon is occasionally responsible. The characteristic colour and smell are the result of the action of digestive enzymes and of bacteria on haemoglobin. Severe acute upper gastrointestinal bleeding can sometimes cause maroon or bright red stool . Ref Davidson edition23rd pg780
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