eだけど、学生レベルでは難しい問題。
cochrane2010の推奨では上部消化管とわかり次第のPPI投与推奨あり。up to date的にはgrade2bでの推奨ですね
up to dateより
We suggest that patients with acute upper GI bleeding be started empirically on an intravenous (IV) PPI (eg, esomeprazole 40 mg IV twice daily after an initial bolus of 80 mg IV). The PPI can be started at presentation and continued until confirmation of the cause of bleeding.