Differential Diagnosis for Upper GI Bleeding
The patient presented with upper GI bleeding that stopped spontaneously, and their blood pressure is within a normal range. Here's a categorized differential diagnosis:
Single most likely diagnosis
- B. Peptic ulcer disease: This is the most common cause of upper GI bleeding, and the fact that the bleeding stopped spontaneously does not rule out this diagnosis. Peptic ulcers can erode into a blood vessel, causing significant bleeding, which may sometimes cease temporarily due to clot formation.
Other Likely diagnoses
- D. Mallory-Weiss: This condition involves tears in the mucous membrane or lining of the lower end of the esophagus, where it connects to the stomach. These tears can bleed, and the bleeding may stop on its own. It's often associated with intense or prolonged vomiting, retching, or coughing but can occur without these symptoms.
- A. Dieulafoy lesion: A rare cause of upper GI bleeding, characterized by a small mucosal defect with an exposed, often large, caliber artery at its base. It can cause significant bleeding that may stop spontaneously.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- C. Esophageal varices: Although less likely given the patient's stable blood pressure and the fact that the bleeding stopped spontaneously, esophageal varices are a critical diagnosis not to miss due to their high mortality rate if ruptured. They are more commonly associated with liver cirrhosis and portal hypertension.
Rare diagnoses
- Other rare causes of upper GI bleeding include vascular anomalies, tumors, and inflammatory conditions. However, these are less likely and would typically present with additional symptoms or findings not mentioned in the scenario provided.