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Haematemesis, jaundice and a hard liver

Clinical caseEmergency4 min
Haematemesis, jaundice and a hard liver

A 55-year-old man presents with two large-volume haematemeses. He is jaundiced with ascites, a hard liver edge and visible abdominal wall veins. HR 115, systolic in the 80s. Transfusion is running; endoscopy is hours away.

Beyond resuscitation, what do you give now?