Mallory–Weiss syndrome

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Mallory–Weiss syndrome
Mallory–Weiss tear
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Hematemesis, melena, abdominal pain
Complications	Hypovolemic shock, anemia
Onset	Sudden
Duration	Usually self-limiting
Types	N/A
Causes	Severe vomiting, retching, coughing
Risks	Alcoholism, hiatal hernia, bulimia nervosa
Diagnosis	Endoscopy
Differential diagnosis	Peptic ulcer disease, esophageal varices, gastritis
Prevention	Avoidance of risk factors
Treatment	Supportive care, endoscopic hemostasis
Medication	Proton pump inhibitors, antiemetics
Prognosis	Generally good with treatment
Frequency	4-8 per 100,000 per year
Deaths	N/A

A condition characterized by tears in the mucous membrane of the esophagus

Mallory–Weiss syndrome

A Mallory-Weiss tear in the esophagus

Mallory–Weiss syndrome is a medical condition characterized by tears in the mucous membrane of the esophagus, where it meets the stomach. These tears can lead to bleeding and are often associated with severe vomiting, retching, or coughing.

Pathophysiology

The tears in Mallory–Weiss syndrome occur at the gastroesophageal junction, which is the area where the esophagus connects to the stomach. The condition is typically caused by a sudden increase in intra-abdominal pressure, which can occur during episodes of forceful vomiting or retching. This pressure can cause the mucosal lining to tear, leading to bleeding.

Causes

Mallory–Weiss syndrome is most commonly associated with:

• Severe or prolonged vomiting
• Retching
• Coughing
• Hiatal hernia
• Alcoholism
• Bulimia nervosa

Symptoms

The primary symptom of Mallory–Weiss syndrome is hematemesis, which is the vomiting of blood. Other symptoms may include:

• Melena (black, tarry stools)
• Abdominal pain
• Dizziness or syncope due to blood loss

Diagnosis

Diagnosis of Mallory–Weiss syndrome is typically made through endoscopy, which allows direct visualization of the tears in the esophagus. During an endoscopy, a flexible tube with a camera is inserted through the mouth into the esophagus and stomach.

Treatment

Treatment for Mallory–Weiss syndrome focuses on stopping the bleeding and addressing the underlying cause. Options may include:

• Endoscopic therapy, such as cauterization or band ligation
• Intravenous fluids to maintain hydration
• Blood transfusions if significant blood loss has occurred
• Medications to reduce stomach acid and prevent further irritation

Prognosis

The prognosis for Mallory–Weiss syndrome is generally good, especially if the condition is promptly diagnosed and treated. Most tears heal without intervention, but severe cases may require more aggressive treatment.

Prevention

Preventive measures for Mallory–Weiss syndrome include:

• Avoiding excessive alcohol consumption
• Managing conditions that cause vomiting or retching
• Treating underlying gastroesophageal reflux disease (GERD)

See also

• Esophagus
• Gastroesophageal reflux disease
• Hiatal hernia
• Endoscopy