A 50 yr old male presented with history of hematemesis – 500 ml of blood and on examination shows BP – 90/60, PR -110/min and splenomegaly 5 cm below lower costal margin. Most probable diagnosis is

Correct Answer: Portal hypertension
Description: Ans. is 'd' i.e. Portal hypertension Causes of Hematemesis (in decreasing order)Peptic ulcerDuodenal ulcer (Most common cause)Gastric ulcerEsophageal varices (portal hypertension)Mallory Weiss tearGastroduodenal erosionsErosive esophagitisNeoplasm of esophagus, stomach & duodenum.Vascular ectasias Here in this patient, splenomegaly is suggestive of portal hypertension.Mallory-Weiss tear is suggested if the patient presents in the classic pattern - initially vomiting is without blood, after retching and vomiting with epigastric pain, hematemesis occurs.Gastritis is usually associated with history of intake of NSAIDS, alcohol, corticosteroids and oral potassium supplements.
Category: Surgery
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