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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 ∼5% 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
  • Greater bleeding associated with:
    • Portal hypertension
    • Esophageal varices
    • Coagulopathy

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Citation

Rosen, Peter, et al., editors. "Mallory–weiss Syndrome." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307639/all/Mallory_weiss_Syndrome.
Mallory–weiss Syndrome. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307639/all/Mallory_weiss_Syndrome. Accessed April 21, 2019.
Mallory–weiss Syndrome. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307639/all/Mallory_weiss_Syndrome
Mallory–weiss Syndrome [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 21]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307639/all/Mallory_weiss_Syndrome.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Mallory–weiss Syndrome ID - 307639 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307639/all/Mallory_weiss_Syndrome PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -