Mallory–Weiss syndrome

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Mallory–Weiss syndrome
Other namesGastro-esophageal laceration syndrome
Mallory–Weiss tear affecting the esophageal side of the gastroesophageal junction
SpecialtyGastroenterology Edit this on Wikidata

Mallory–Weiss syndrome or gastro-esophageal laceration syndrome refers to bleeding from a laceration in the

bulimia,[2] but can be caused by any condition which causes violent vomiting and retching such as food poisoning. The syndrome presents with hematemesis
. The laceration is sometimes referred to as a Mallory–Weiss tear.

Signs and symptoms

Mallory–Weiss Syndrome often presents as an episode of vomiting up blood (hematemesis) after violent retching or vomiting, but may also be noticed as old blood in the stool (melena), and a history of retching may be absent.

In most cases, the bleeding stops spontaneously after 24–48 hours, but

surgical treatment is sometimes required. The condition is rarely fatal.[citation needed
]

Causes

It is often associated with

NSAID abuse is also a rare association.[4] In rare instances some chronic disorders like Ménière's disease
that cause long term nausea and vomiting could be a factor.

The tear involves the mucosa and submucosa but not the muscular layer (contrast to

Boerhaave syndrome which involves all the layers).[5] Most patients are between the ages of 30 and 50 years, although it has been reported in infants aged as young as 3 weeks, as well as in older people.[6][7] Hyperemesis gravidarum, which is severe morning sickness associated with vomiting and retching in pregnancy, is also a known cause of Mallory–Weiss tear.[8]

Diagnosis

Definitive diagnosis is by endoscopy of the esophagus and stomach.[9] Proper history taking by the medical doctor to distinguish other conditions that cause haematemesis but definitive diagnosis is by conducting esophagogastroduodenoscopy.[10][11][12]

Treatment

Treatment is usually supportive as persistent bleeding is uncommon. However

epinephrine[13] to stop the bleeding may be undertaken during the index endoscopy procedure. Very rarely embolization of the arteries supplying the region may be required to stop the bleeding. If all other methods fail, high gastrostomy
can be used to ligate the bleeding vessel. A Blakemore tube will not be able to stop bleeding as here the bleeding is arterial and the pressure in the balloon is not sufficient to overcome the arterial pressure.

History

The condition was first described in 1929 by

G. Kenneth Mallory and Soma Weiss in 15 alcoholic patients.[14]

See also

References

  1. ^ "Mallory-Weiss Syndrome (Mallory-Weiss Tear)". The Lecturio Medical Concept Library. 28 July 2020. Retrieved 10 August 2021.
  2. ISBN 9780983224600
    .
  3. PMID 2657497
    .
  4. PMID 2287873
    .
  5. ^ Boerhaave Syndrome at eMedicine
  6. PMID 10941865
    .
  7. PMID 8072208
    .
  8. PMID 19772708
    .
  9. PMID 7304810
    .
  10. BUPA. December 2006. Archived from the original
    on 2007-10-06. Retrieved 2007-10-07.
  11. ^ National Digestive Diseases Information Clearinghouse (November 2004). "Upper Endoscopy". National Institutes of Health. Archived from the original on 2007-10-24. Retrieved 2007-10-07.
  12. ^ "What is Upper GI Endoscopy?". Patient Center -- Procedures. American Gastroenterological Association. Archived from the original on 2007-09-28. Retrieved 2007-10-07.
  13. S2CID 195343875
    .
  14. doi:10.1001/jama.1932.02730420011005
    .

External links

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