A 46-Year-Old Man Is Brought to the Emergency Department by Paramedics

A 46-year-old man is brought to the emergency department by paramedics after an episode of large-volume hematemesis.  He was going over some papers at work when he suddenly felt nauseated and started vomiting up bright red blood.  Physical examination reveals a palpable spleen.  Endoscopy shows bleeding esophageal varices.  A liver biopsy performed 2 days later shows no abnormalities.  Which of the following is the most likely cause of this patient's condition?

A) Acetaminophen toxicity
B) Long-term alcohol consumption
C) Budd-Chiari syndrome
D) Constrictive pericarditis
E) Portal vein thrombosis

Correct Answer:

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