An old man presenting to the Emergency following about of prolonged vomiting with excessive haematemesis following alcohol ingestion is likely to suffer from
**Core Concept**
The patient's presentation of prolonged vomiting with excessive haematemesis following alcohol ingestion suggests a severe gastrointestinal complication. The underlying pathophysiology involves acute gastric mucosal injury, leading to bleeding.
**Why the Correct Answer is Right**
The most likely cause of this patient's condition is acute gastric mucosal injury, also known as stress gastritis. This condition is often seen in patients with a history of alcohol abuse, as it can cause direct mucosal damage and compromise the protective mechanisms of the gastric mucosa. The mechanism of injury involves the release of gastric acid and pepsin, leading to mucosal damage and bleeding.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because while Mallory-Weiss syndrome is a possible cause of upper GI bleeding, it is typically associated with intense or prolonged vomiting, retching, or coughing, not necessarily following alcohol ingestion.
**Option B:** This option is incorrect because gastritis is a common cause of upper GI symptoms, but it is not the most likely cause of severe bleeding in this context.
**Option C:** This option is incorrect because esophageal varices are a complication of liver cirrhosis, which is not directly related to the patient's presentation of prolonged vomiting and haematemesis following alcohol ingestion.
**Clinical Pearl / High-Yield Fact**
It is essential to note that patients with a history of alcohol abuse are at an increased risk of developing stress gastritis, which can be a life-threatening condition if not promptly treated.
**Correct Answer: B. Gastritis. Gastritis**