MalloryWeiss

Mallory-Weiss syndrome, also known as Mallory-Weiss tear, is a medical condition defined by longitudinal mucosal lacerations at the gastroesophageal junction caused by forceful retching or vomiting. These tears can lead to upper gastrointestinal bleeding, most often presenting as hematemesis.

The tears involve the mucosa and sometimes the submucosa at the gastroesophageal junction and are typically the result of severe or prolonged vomiting or retching. They are commonly associated with acute alcohol intoxication, binge drinking, bulimia, or recent gastroenteritis. Additional risk factors can include hiatal hernia, peptic ulcers, and coagulopathy, which may worsen bleeding.

Clinical presentation usually follows a bout of retching with sudden onset of vomiting blood. The bleeding is often self-limited but can be significant in some cases. Patients may report chest or abdominal pain and, less commonly, melena. Diagnosis is usually confirmed by endoscopy, which reveals the characteristic tears and helps exclude other causes of upper gastrointestinal bleeding such as esophageal varices, ulcers, or gastritis.

Management centers on supportive care and stabilization, including intravenous fluids and blood transfusion if needed, along with antiemetics and proton pump inhibitors. Most bleeds stop spontaneously within 24 to 48 hours. Endoscopic hemostasis may be necessary for ongoing or recurrent bleeding. Addressing underlying factors, such as alcohol cessation, is important. The prognosis is generally favorable with appropriate treatment; mortality is low but increases with severe bleeding or serious comorbid conditions.

Mallory-Weiss tears were first described by Phillips Mallory and Jason Weiss in 1929. The condition is more common in adults and is a recognized cause of upper gastrointestinal bleeding.

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