A 58 years old man previously alcoholic, and working as a carpet factory supervisor, having bouts of haematemesis yearly since last three years with out any reason, No cause can be a certained. The CT scan of thorax , chest, and abdomen are normal. He was examined three times by gastroscopy, only once he had Mallory Weiss tear and Dielfoy lesion ( Altered blood in fundus) and two times found normal. Today I noticed a small lymphnode secondary in neck.
His CBC, urea, creatinine, hemoglobin all are found normal done many times amylase lipase also found normal. He was also provided with H pylori kit. What can be the cause of haematemesis ?
