Snapshot A 53-year-old man with a history of gastroesophageal reflux and alcohol abuse is brought to the emergency room by his family due to acute chest and back pain. He endorses alcohol use throughout the day and has been feeling very nauseated with emesis throughout the night. On evaluation, his blood pressure is 105/72 mmHg and pulse is 92/min. He had 1 episode of emesis with bright red blood in the room. Introduction Clinical definition login to view 1 more bullet Epidemiology Up to 15% of all upper gastrointestinal bleeding Demographics login to view 2 more bullets Risk factors login to view 4 more bullets ETIOLOGY Pathogenesis login to view 5 more bullets Presentation Symptoms login to view 5 more bullets Physical exam login to view 2 more bullets Studies Diagnostic testing login to view 3 more bullets Differential Reflux esophagitis login to view 2 more bullets Boerhaave syndrome login to view 2 more bullets Treatment Management approach login to view 10 more bullets First-line login to view 3 more bullets Second-line login to view 3 more bullets Third-line login to view 3 more bullets Complications Rebleed Myocardial ischemia or infarction Hypovolemic shock Death