PATHOLOGY Gastro N* Q-8

[Roxanita]

A 48-year-old man with a long history of alcohol abuse has painless vomiting of large amounts of bright red blood. Heart rate is 110/min and blood pressure is 80/0 mm Hg. He dies despite rapid transfusion of packed erythrocytes. At autopsy, the source of the hemorrhage is found in the lower esophagus. Which of the following mechanisms most likely caused the hemorrhage?


A) Alcohol-induced esophagitis

B) Deficiency in hepatic synthesis of vitamin K-dependent coagulation proteins

C) Mechanical tearing of the esophageal mucosa during vomiting

D) Peptic ulceration of esophageal mucosa due to reflux of gastric acid

E) Transmission of portal hypertension to esophageal veins

[Lorena]

E) Transmission of portal hypertension to esophageal veins

The source of the hemorrhage is found in the lower esophagus (a branch of portal vein is left gastric vein that drains the distal esophagus and proximal stomach)
Rupture of esophageal varices is MC complication and COD in cirrhosis

[shawky2005]

E) Transmission of portal hypertension to esophageal veins