A 42 year old company executive presents with sudden upper GI bleed (5 litres) of bright red blood, with no significant previous history. The diagnosis is?

Ans. is 'b' i.e., Duodenal ulcer Both esophageal varices and duodenal ulcer are causes of massive upper GI bleed. Although it is difficult to reach a diagnosis by clinical history and physical examination alone, variceal bleed is less likely as there are no stigmata of chronic liver disease or poal hypeension.