<prompt> A 50 year old male presented with history of hematemesis - 500ml of blood and on examination shows BP- 9060, PR-110bpm and splenomegaly 5cm below lower costal margin. Most probable diagnosis isMalory-weiss tearDuodenal ulcerGastritisPoal hypeension  <response>: Splenomegaly and massive bleeding leading to hypotension are in our of poal hypeension. Common causes of upper Gastrointestinal Hemorrhage Non-variceal bleeding 80 Poal Hypeensive Bleeding 20 Peptic ulcer disease MC 30-40 Gastroesophageal varices 90 Malory-weiss tear 15-20 Hypeensive poal gastropathy 5 Gastritis or duodenitis 10-15 Isolated gastric varices 5 Esophagitis 5-10 Aeriovenous malformations 5 Tumors 2 Others 5 Ref: Sabiston 20th edition Pgno : 1142 