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Acute upper gastrointestinal hemmorhage is an important medical emergency. Most of the patients are over the age of 60 years.The vomitus is usually fresh blood or appears as coffee grounds. It is almost always associated with some degree of blood in the stools. Early diagnosis is needed to save the patient. The most common causes which occur and which can be misdiagnosed include duodenal ulcer, gastric erosion and ulcer, reflux oesophagitis, oesophageal varices and Mallory- Weiss syndrome. It is important to elicit a good history and the general condition of the patient must be assessed particularly the circulation immediately on presentation.
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