Mallory–weiss Syndrome

Mallory–weiss Syndrome is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • Partial-thickness intraluminal longitudinal mucosal tear of distal esophagus or proximal stomach
  • Sudden increase in intra-abdominal and/or transgastric pressure causes:
    • Mild to moderate submucosal arterial and/or venous bleeding:
      • May be related to underlying pathology
      • “Mushrooming” of stomach into esophagus during retching has been observed endoscopically.
    • Responsible for ∼8–15% of all cases of upper GI bleeding

Etiology

  • Associated with:
    • Forceful coughing, laughing, or retching
    • Lifting
    • Straining
    • Blunt abdominal trauma
    • Seizures
    • Childbirth
    • Cardiopulmonary resuscitation
  • Risk factors:
    • Alcoholics:
      • Especially after recent binge
    • Patients with hiatal hernia
    • Hyperemesis gravidarum
    • Diabetic ketoacidosis
    • Chemotherapy
  • Greater bleeding associated with:
    • Portal hypertension
    • Esophageal varices
    • Coagulopathy

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Basics

Description

  • Partial-thickness intraluminal longitudinal mucosal tear of distal esophagus or proximal stomach
  • Sudden increase in intra-abdominal and/or transgastric pressure causes:
    • Mild to moderate submucosal arterial and/or venous bleeding:
      • May be related to underlying pathology
      • “Mushrooming” of stomach into esophagus during retching has been observed endoscopically.
    • Responsible for ∼8–15% of all cases of upper GI bleeding

Etiology

  • Associated with:
    • Forceful coughing, laughing, or retching
    • Lifting
    • Straining
    • Blunt abdominal trauma
    • Seizures
    • Childbirth
    • Cardiopulmonary resuscitation
  • Risk factors:
    • Alcoholics:
      • Especially after recent binge
    • Patients with hiatal hernia
    • Hyperemesis gravidarum
    • Diabetic ketoacidosis
    • Chemotherapy
  • Greater bleeding associated with:
    • Portal hypertension
    • Esophageal varices
    • Coagulopathy

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