Q:

A 45 year old male alcoholic presents after a large hematemesis. He has some spider naevi on his chest, BP 100/76mmHg, pulse 110bpm. He has a swollen abdomen with shifting dullness

waelhammad
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2022-11-03
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A 45 year old male alcoholic presents after a large hematemesis. He has some spider naevi on his chest, BP 100/76mmHg, pulse 110bpm. He has a swollen abdomen with shifting dullness.

  1. Gastric ca
  2. Mallory-weiss tear
  3. Esophageal ca
  4. Esophageal varices
  5. Esophagitis
  6. Peptic ulceration
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waelhammad
2022-11-03
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The key is D. Esophgeal varices. [Spider nevi and ascites suggest advanced liver disease. Here in alcoholic middle aged man having large hematemesis with above mentioned features are very suggestive of bleeding from esophageal varices secondary to portal hypertension in liver cirrhosis].

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