A 50 year old male presented with history of hematemesis - 500ml of blood and on examination shows BP- 90/60, PR-110bpm and splenomegaly 5cm below lower costal margin. Most probable diagnosis is: (A) Malory-weiss tear, (B) Duodenal ulcer, (C) Gastritis, (D) Poal hypeension
Answer is D. Splenomegaly and massive bleeding leading to hypotension are in our of poal hypeension. Common causes of upper Gastrointestinal Hemorrhage Non-variceal bleeding (80%) Poal Hypeensive Bleeding (20%) Peptic ulcer disease (MC) 30-40% Gastroesophageal varices >90% Malory-weiss tear 15-20% Hypeensive poal gastropathy <5% Gastritis or duodenitis 10-15% Isolated gastric varices <5% Esophagitis 5-10% Aeriovenous malformations 5% Tumors 2% Others 5% Ref: Sabiston 20th edition Pgno : 1142