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Mallory-Weiss syndrome

Last updated: March 20, 2020

Summary

Mallory-Weiss syndrome refers to acute upper gastrointestinal bleeding caused by mucous membrane lacerations at the gastroesophageal junction, although it may extend above or below. Forceful vomiting in the presence of a damaged gastric mucous membrane, often related to alcoholism, is a common cause of Mallory-Weiss syndrome. Patients typically present with a history of epigastric pain and hematemesis. Esophagogastroduodenoscopy is important in both the diagnosis of the condition and its treatment, which involves simultaneous hemostasis.

Definition

Think of the double L in MaLLory-Weiss to remember Longitudinal Lacerations.

Epidemiology

References:[1][2]

Epidemiological data refers to the US, unless otherwise specified.

Etiology

References: [2]

Clinical features

References:[2]

Diagnostics

References:[2]

Differential diagnoses

The differential diagnoses listed here are not exhaustive.

Treatment

General measures

  • If bleedings stops spontaneously conservative treatment is usually sufficient
  • Control of precipitating factors (e.g., omeprazole for GERD)
  • Inpatient monitoring
  • Treat hemodynamic instability if present

Surgical treatment

References:[1][2]

Acute management checklist

References

  1. Song LMWK. Mallory-Weiss Tear Overview of Mallory-Weiss Syndrome. In: Katz J, Mallory-Weiss Tear Overview of Mallory-Weiss Syndrome. New York, NY: WebMD. http://emedicine.medscape.com/article/187134-overview#showall. Updated: June 25, 2015. Accessed: January 4, 2017.
  2. Guelrud M. Mallory-Weiss syndrome. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/mallory-weiss-syndrome.Last updated: March 18, 2014. Accessed: January 4, 2017.
  3. Kim H-S. Endoscopic Management of Mallory-Weiss Tearing. Clin Endosc. 2015; 48 (2): p.102. doi: 10.5946/ce.2015.48.2.102 . | Open in Read by QxMD
  4. Mallory Weiss Syndrome. https://www.ncbi.nlm.nih.gov/books/NBK538190/. Updated: November 24, 2019. Accessed: January 6, 2020.
  5. Loffroy R, Favelier S, Pottecher P, et al. Transcatheter arterial embolization for acute nonvariceal upper gastrointestinal bleeding: Indications, techniques and outcomes. Diagn Interv Imaging. 2015; 96 (7-8): p.731-744. doi: 10.1016/j.diii.2015.05.002 . | Open in Read by QxMD
  6. Herold G. Internal Medicine. Herold G ; 2014