A 27-year-old man presents to the ED with a 2-day history of hyperemesis with hematemesis. He complains of worsening epigastric pain, diarrhea, and myalgia. On examination, the patient is severely dehydrated and agitated, with tenderness to palpation noted in the upper chest and neck. The patient drank 21 cans of beer 3 days ago; his history reveals that he has vomited 30 times in the past 24 hours.

what is the most probable Dx?

i found these cases in emedicine and i want to share them with u....

fulminant hepatic failure !?

thanks for sharing

yeah i saw this case on the e-medicine...the dx was fad shee emra3bal mo?

the diagnosis is Borhaav's syndrom (complete tear of the GE junction)...this hint in the history was that he has nomitted 30 times in the past 24 hours....

THANKS DOC.

case n7sa 7eeeel

Mallory-Weiss syndrome complicated by repture of esophagues