A patient presents with a large-volume upper GI bleed. Which of the following is a recognised cause of upper GI bleeding to consider alongside oesophageal varices?

Answer: D. A Mallory-Weiss tear at the cardia after violent vomiting

Causes of upper GI bleeding

Upper GI bleeding arises proximal to the duodenojejunal flexure. Recognising the range of causes guides endoscopic assessment.

Common causes

Why the distinction matters

• In a cirrhotic, varices are the priority, but other causes (e.g. peptic ulcer) are common and endoscopy distinguishes them.
• The Mallory-Weiss tear classically follows a bout of violent vomiting/retching.

Lower GI causes (for contrast)

Diverticulosis, haemorrhoids, angiodysplasia of the colon and anal fissures cause lower GI bleeding, not upper.