A 33-Year-Old Man Comes to the Emergency Department Due to Abdominal

question 1464

Multiple Choice

A 33-year-old man comes to the emergency department due to abdominal discomfort, nausea, and 2 episodes of vomiting containing a small amount of blood over the past several hours.  The symptoms all started this morning.  He has no prior medical problems and has never had similar symptoms.  The patient drank alcohol and used cocaine with his friends late last night.  This morning, he woke up with a "terrible" headache for which he took several aspirin tablets.  The headache improved, but he subsequently developed the gastrointestinal symptoms.  The patient smokes a pack of cigarettes daily and drinks 1 or 2 cans of beer daily.  Vital signs are normal.  Abdominal examination reveals mild epigastric tenderness, but no masses, rebound, or guarding.  Which of the following is the most likely cause of this patient's hematemesis?

• A)Abnormal aortoenteric communication
• B)Dilated esophageal vessels
• C)Gastric mucosal erosion
• D)Heat-stable enterotoxin ingestion
• E)Pancreatic autodigestion injury
• F)Partial esophageal tear