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Emerg Med J 30:259 doi:10.1136/emermed-2012-201589
  • Images in emergency medicine

Coffee-ground vomit and subdiaphragmatic air

  1. Jack Pottle
  1. Ealing Hospital, Southall, London, UK
  1. Correspondence to Dr Jack Pottle, Ealing Hospital, Southall, London UB1 3HW, UK; jackpottle{at}hotmail.com
  • Accepted 10 June 2012
  • Published Online First 4 July 2012

Summary

A 90-year-old nursing home resident was admitted with confusion and reported ‘coffee-ground’ vomit. A chest radiograph was performed.

Coffee-ground vomit and subdiaphragmatic air

A 90-year-old female nursing home resident was found minimally responsive by her carers with a reported history of ‘coffee-ground’ vomit. She had a past medical history of Alzheimer's dementia and recent humeral fracture. Her only regular medication was lansoprazole 30 mg OD.

On arrival to the emergency department she was in circulatory shock with a blood pressure of 73/54 and pulse rate of 143 beats per minute. Respiratory rate was 44 and she was feverish at 38.2°C. …


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