Which immediate action is best: abdominal pain, syncope, hypotension, pulsatile abdominal mass?
QUESTION
Identify the likely diagnosis: sudden severe abdominal pain with rigid abdomen and rebound tenderness.
QUESTION
Identify the likely cause: cirrhosis history plus hematemesis and hypotension.
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ANSWER
Esophageal variceal hemorrhage. Cirrhosis leads to portal hypertension and varices, which can rupture, causing massive upper GI bleeding and subsequent hemodynamic instability.