ABSTRACT
A 57-year-old man was admitted to hospital complaining of several episodes of coffee ground vomiting. He described approximately 10 episodes of vomiting around 100 mL coffee ground matter over the preceding 24 hours. He reported symptoms of light-headedness and weakness, which had come on gradually over the past few hours. He had epigastric pain and complained of ‘heart burn’ whenever he tried to eat or drink. His past medical history included a hospital admission 6 months earlier with a bleeding duodenal ulcer, which required a laparotomy and a 14 unit blood transfusion. His regular prescribed medications included 20 mg omeprazole OD, which he admitted to only taking around once weekly. He had previously worked as a teacher but had been unemployed over recent years. He admitted to drinking a bottle of vodka (30 units) and smoking 40 cigarettes per day for the past 15 years. He lived alone and had not travelled abroad recently. He had no current sexual partners.
