<prompt> A 50 yr old male presented with history of hematemesis - 500 ml of blood and on examination shows BP - 9060, PR -110min and splenomegaly 5 cm below lower costal margin. Most probable diagnosis isMallory Weiss tearDuodenal ulcerGastritisPortal hypertension  <response>: Ans. is d i.e. Portal hypertension Causes of Hematemesis in decreasing orderPeptic ulcerDuodenal ulcer Most common causeGastric ulcerEsophageal varices portal hypertensionMallory Weiss tearGastroduodenal erosionsErosive esophagitisNeoplasm of esophagus, stomach duodenum.Vascular ectasias Here in this patient, splenomegaly is suggestive of portal hypertension.Mallory-Weiss tear is suggested if the patient presents in the classic pattern - initially vomiting is without blood, after retching and vomiting with epigastric pain, hematemesis occurs.Gastritis is usually associated with history of intake of NSAIDS, alcohol, corticosteroids and oral potassium supplements. 