Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with [hematemesis/melena/hematochezia]. Known history of Pseudoxanthoma Elasticum (PXE). Current episode characterized by [onset/duration/severity]. No prior history of peptic ulcer disease or coagulopathy. Review of systems positive for [skin changes/visual disturbances]. Hemodynamic status: [stable/unstable].
Clinical Examination Findings
Physical exam reveals characteristic "plucked chicken" skin lesions on the neck, axillae, and antecubital fossae. Abdominal exam: [soft/distended/tender/guarding]. Digital rectal exam: [positive/negative for melena]. Ocular exam: [presence/absence of angioid streaks]. Cardiovascular: [tachycardia/hypotension/normal].
Treatment Protocol
Immediate stabilization with IV fluids and blood product transfusion as indicated. Gastroenterology consultation for urgent EGD/colonoscopy to localize bleeding source. Consider endoscopic hemostasis (clips/cautery). Avoid NSAIDs and antiplatelet agents. Monitor hemoglobin/hematocrit levels closely.