A male executive, 50 year of age is seen in casualty with hematemesis. He had vomited whole food that he had taken before the hematemesis followed by forceful retching. There is history of alcohol intake on previous day. Most probable diagnosis is:
Mallory-Weiss tear consists of a 1- to 4-cm longitudinal tear in the gastric mucosa near the esophagogastric junction. The majority of patients are alcoholics, but the tear may appear after severe retching for any reason. Typically, the patient first vomits food and gastric contents. This is followed by forceful retching and then bloody vomitus. In about 90% of patients, the bleeding stops spontaneously after ice-water lavage of the stomach. Ref: Dohey G.M., Way L.W. (2010). Chapter 23. Stomach & Duodenum. In G.M. Dohey (Ed), CURRENT Diagnosis & Treatment: Surgery, 13e.
Gastritis
Duodenal ulcer
Mallory-Weiss tear
Esophageal varices