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Differential Diagnosis for Vomiting of Blood after Physical Assault

Single Most Likely Diagnosis

  • Mallory-Weiss Tear: This is a common cause of vomiting blood (hematemesis) after physical assault, especially if the assault involved blunt trauma to the abdomen or chest, leading to forceful vomiting or retching, which can cause a tear in the mucous membrane or submucosa of the lower end of the esophagus.

Other Likely Diagnoses

  • Gastritis: Physical assault can lead to stress, which may exacerbate or trigger gastritis, an inflammation of the stomach lining, potentially causing bleeding.
  • Peptic Ulcer Disease: Stress from physical assault can also exacerbate peptic ulcers, leading to bleeding.
  • Esophageal Tear (not limited to Mallory-Weiss): Besides Mallory-Weiss tears, other types of esophageal injuries from trauma can cause hematemesis.

Do Not Miss Diagnoses

  • Boerhaave's Syndrome: A severe and life-threatening condition where there is a full-thickness tear of the esophagus, often associated with forceful vomiting. It requires immediate medical attention.
  • Aortic Injury: Although rare, severe physical assault can lead to aortic injuries, which might present with hematemesis among other symptoms due to the proximity of the aorta to the esophagus and stomach.
  • Splenic Injury: Bleeding from a splenic injury can occasionally present with hematemesis if there is a connection between the spleen and the stomach (e.g., through a fistula), though this is rare.

Rare Diagnoses

  • Dieulafoy's Lesion: A rare cause of gastrointestinal bleeding, characterized by a small mucosal defect with an exposed, usually large, caliber artery at its base.
  • Hemobilia: Bleeding into the biliary tree, which can be a result of trauma and might present with hematemesis among other symptoms like melena (black, tarry stools) and jaundice.
  • Traumatic Pseudoaneurysm of the Gastroduodenal Artery: A rare complication of abdominal trauma, which can cause gastrointestinal bleeding.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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