A Rare Case of Haematemesis in a Newborn

作者：Birkholz T^*; Schmidt J; Schnelke A

来源：Notarzt, 2009, 25(6): 204-207.

DOI：10.1055/s-2008-1067460

• out-of-hospital
• emergency medicine
• pediatric emergency
• haematemesis
• neonate

Pediatric emergencies are only a small part of all out-of-hospital emergencies, but raises fears in the majority of the emergency physicians. Haematemesis in a mature newborn is rare but an alarming clinical picture. Amongst others, ingestion of maternal blood, erosive gastritis caused by milk protein sensitivity and trauma by a nasogastric tube should to be taken into account. The emergency physician was alarmed to respond to "Haematemesis in a toddler" and found a four-day-old newborn with bloody face, which was vitally completely stable. The haematemesis occurred after brestfeeding and was not accompanied by clinical deterioration or agitation. The mother reported a chestnut-sized dark coagel, which was already disposed. In respect to the discrepancy between amount of blood and the neonates' clinical situation, the clinical examination was expanded to the mother. This revealed cracked nipples in the mother, which has lead to blood ingestion by the newborn. Neonatal haematemesis must be evaluated in respect to a neonatal source of the blood. As a simple examination, the mother's mammillae could be examined. In this case, successful resolving of the case with clinical measures underlines the need for a comprehensive education in emergency medicine, which might show some pediatric emergency in a different light.

• 出版日期2009-12