<prompt> A patient after heavy drinking of alcohol presents with too much vomiting haematemesis. Most likely diagnosis could be: March 2012, March 2013Mallory Weiss syndromeOesophageal carcinomaAchalasia cardiaBoerhaave syndrome  <response>: Ans: A i.e. Mallory Weiss syndromeEsophagus disorders presentationIn Mallory Weiss syndrome, vigorous vomiting produces a veical split in gastric mucosa, immediately below the squamo-columnar junction at the cardia in 90 of cases. The condition presents with haematemesisMost oesophageal neoplasms presents with mechanical symptoms, principally dysphagia, but sometimes also regurgitation, vomiting, odynophagia weight lossAchalsia cardia presents with dysphagia, although pain often mistaken for reflux is common in the early stages.In Boerhaaves syndrome, vomiting occurs against a closed glottis, and pressure builds up in the oesophagus 