A man taking regular NSAIDs vomits coffee-ground material and passes black tarry stools. What is the most likely diagnosis?
Answer and explanation
Correct answer: B. Bleeding duodenal ulcer
- Step 1: The picture of melaena with coffee-ground vomit fits Bleeding duodenal ulcer.
Answer
Bleeding duodenal ulcer.
Why not the others: 'Bleeding oesophageal varices': varices bleed profusely in patients with portal hypertension or known cirrhosis. 'Mallory-Weiss tear': a tear follows forceful retching and the bleed is usually self-limiting. 'Gastric carcinoma': carcinoma gives weight loss and anaemia over weeks.
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