A 25yo male with a hx of frequent binge drinking presents 4h after having had a take away meal
following a nights heavy drinking. He complains of nausea and has vomited on several occasions.
After the last vomiting episode, he vomited approximately a cupful of blood. On admission, he
smells of alcohol, pulse=100bpm, BP=140/80mmHg. He has some tenderness in the epigastrium.
What is your dx?
a. Gastric carcinoma
b. Mallory-weiss tear
c. Esophageal carcinoma
d. Esophageal varices
e. Esophageal varices
f. Peptic ulceration
Ans. The key is Mallory-weiss tear. [Repeated retching and vomiting is a recognized cause of Malloryweiss tear which is supported here by vomiting a cupful of blood