ABSTRACT
Q1 A previously well 3-year-old presented with an upper respiratory tract infection and had been retching and vomiting small amounts of blood. She is growing well and has a normal examination. The most likely diagnosis is: A non-steroidal anti-inflammatory drug gastropathy B Mallory-Weiss’s tear C haemorrhagic gastritis D peptic ulcer E vascular malformation
A1 B A Mallory-Weiss’s tear is an acute mucosal laceration of the gastric cardia or gastro-oesophageal junction. The classic presentation is haematemesis following repeated retching or vomiting. Abdominal pain is uncommon and is most likely to be musculoskeletal in origin because of the forceful retching. Vomiting episodes are usually related to a concurrent viral illness, and occur in previously well children with normal growth patterns and with no history of vomiting or loose stools.
