What cause of massive blood vomiting?

Esophageal varices: These are enlarged veins that develop in the esophagus due to increased pressure in the portal vein, which carries blood from the intestines, spleen, and pancreas to the liver. When portal vein pressure increases, the blood backs up into the esophagus, causing the veins to swell. Vomiting with esophageal varices can profuse, leading to massive blood vomiting and sometimes death if not treated promptly.