{"ops":[{"insert":"A 55-year-old man with end-stage cirrhosis secondary to alcohol abuse presents around 30 minutes after vomiting a large amount of bright red blood. This is his first such episode.\n\nAn endoscopy around a year ago revealed multiple grade IV esophageal varices, which were ligated at that time. He has also been on oral propranolol therapy since then.\n\nHis medical and surgical histories are otherwise unremarkable. He has continued to consume half a bottle of whiskey a day, against medical advice.\n"},{"insert":"\n"},{"insert":{"image":"\/storage\/case-images\/pd\/PD-M-240_en.png"}},{"insert":"\n"}]}
