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GI Bleed

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Q )  A 59 year old male alcoholic male presents with history of upper GI bleed of 1 day duration. During the day he has had three episodes of bleeding each time about 150 ml. Blood is fresh and not associated with retching. He has a history of long standing alcohol intake. What will be the most likely cause of GI bleed?

a) Mallory weiss tear

b) Esophageal varices

c) Gastric ulcer

d) Esophagitis

11 b

Long standing alcohol intake means some stigma of liver disease leading to chronic liver disease and consequently esophageal varices. 

Mallory Weiss tear occurs with retching and after episodes of binge drinking

Gastric and duodenal ulcers are related to alcohol but usually presents at 40 years 

Esophagitis will have associated symptoms of GERD and long standing history

Mass forming lesion Liver

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Q) A 55 year old male presents with obstructive jaundice. Ultrasound evaluation reveals a

hyperechoic 4 cm mass in segment VI of liver with peripheral duct dilatation.

CT abdomen shows a hypodense mass with delayed enhancement in portal pahse.

What is the most likely diagnosis

a) Hepatocellular carcinoma

b) Intrahepatic cholangiocarcinoma

c) Metastatic Adenocarcinoma

d) Carcinoid 

b) Intrahepatic cholangiocarcinoma (IHCC)

IHCC - Mass forming type- have gradual central enhancement and variable delayed enhancement on portal phase

Hepatocellular carcinoma present ....Premium content at Questions on Bile ducts Q16-20

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