Differential Diagnosis for Coffee Ground Vomit
- Single Most Likely Diagnosis
- Gastroesophageal reflux disease (GERD) with esophagitis or gastritis: This condition is a common cause of coffee ground vomit due to the reflux of stomach acid into the esophagus, leading to inflammation and bleeding.
- Other Likely Diagnoses
- Peptic ulcer disease (PUD): Ulcers in the stomach or duodenum can bleed, leading to coffee ground vomit.
- Gastritis: Inflammation of the stomach lining can cause bleeding and lead to coffee ground vomit.
- Esophageal varices: Enlarged veins in the esophagus, often due to liver disease, can bleed and cause coffee ground vomit.
- Do Not Miss Diagnoses
- Upper gastrointestinal malignancy: Although less common, tumors in the esophagus, stomach, or duodenum can cause bleeding and lead to coffee ground vomit. Missing this diagnosis could be fatal.
- Hematemesis due to a bleeding disorder: Conditions like hemophilia or von Willebrand disease can increase the risk of bleeding in the upper GI tract, leading to coffee ground vomit.
- Mallory-Weiss syndrome: A tear in the mucous membrane of the lower end of the esophagus can cause bleeding and lead to coffee ground vomit.
- Rare Diagnoses
- Dieulafoy's lesion: A rare condition where a small artery in the stomach wall erodes, leading to bleeding and coffee ground vomit.
- Gastric antral vascular ectasia (GAVE): A rare condition characterized by vascular ectasias in the stomach, which can cause bleeding and lead to coffee ground vomit.
- Ingestion of a caustic substance: Although rare, ingestion of a caustic substance can cause severe esophageal and gastric damage, leading to bleeding and coffee ground vomit.