Hematemesis in a Man with Known Cirrhosis

Presentation

A 58-year-old man with alcohol-related cirrhosis (Child-Pugh B) presents after vomiting bright red blood twice at home and passing a black tarry stool this morning. He has a history of ascites and known esophageal varices seen on prior endoscopy. He appears pale and diaphoretic.

T 36.8°C, HR 118, BP 92/58, RR 20, SpO2 97% on room air