Question

You are treating a 58-year-old male with abdominal pain and fatigue. He states that his stools have been dark and tarry. His abdomen is tender to palpation. Which of the following is the likely cause of his condition?

A - A ruptured liver.
B - A ruptured appendix.
C - An upper gastrointestinal bleed.
D - A lower abdominal bleed.

Answer 1

The description of dark, tarry stools and abdominal pain in a 58-year-old male likely indicates an upper gastrointestinal bleed, potentially from peptic ulcers, rather than a ruptured liver, appendix, or lower abdominal bleed.

Step-by-step explanation:

When treating a 58-year-old male who is presenting with abdominal pain and fatigue, and describes his stools as dark and tarry, indicating the presence of digested blood, the likely cause of his condition is an upper gastrointestinal bleed (UGIB). The dark, tarry stools, known as melena, suggest that the bleeding source is above the ileocecal valve where the small intestine meets the large intestine. Additional symptoms such as nausea, lack of appetite, bloating, and weight loss are commonly associated with peptic ulcers, one of the primary causes of upper gastrointestinal bleeding. After the physician orders a stool sample to rule out certain infections which can also cause bloody stools, the persistence of melena, alongside abdominal tenderness, would more definitively indicate an upper gastrointestinal issue rather than a lower abdominal bleed or conditions such as a ruptured liver or appendix, which would typically present differently.