ABSTRACT
This chapter presents information or guidance regarding gastroenterology for use by medical, scientific or health-care professionals. Haematemesis carries a mortality rate of 10" and is treated as a medical emergency. There are many causes of haematemesis but the simplest explanation is likely to be the correct one e.g. oesophageal varices in a chronic alcoholic; Mallory–Weiss tear after an alcohol binge; gastric erosions or a bleeding peptic ulcer in patients on long-term anti-inflammatories. Jaundice is usually classified as pre-hepatic, hepatic or post-hepatic and a good history should establish which of these is most likely to be the underlying cause. Remember, jaundice may occasionally reflect a combination of both hepatic and post-hepatic causes. The key to the OSCE history is to identify whether the jaundice is pre-, intra- or post-hepatic and then to isolate the most likely aetiology. The differential diagnosis for jaundice is vast.
