Mallory-Weiss syndrome

Mallory-Weiss syndrome

Infobox_Disease
Name = PAGENAME


Caption =
DiseasesDB = 7803
ICD10 = ICD10|K|22|6|k|20
ICD9 = ICD9|530.7
ICDO =
OMIM =
MedlinePlus =
eMedicineSubj = ped
eMedicineTopic = 1359
MeshID = D008309

Mallory-Weiss syndrome refers to bleeding from tears (a "Mallory-Weiss tear") in the mucosa at the junction of the stomach and esophagus, usually caused by severe retching, coughing, or vomiting.

Causes

It is often associated with alcoholismcite journal |author=Caroli A, Follador R, Gobbi V, Breda P, Ricci G |title= [Mallory-Weiss syndrome. Personal experience and review of the literature] |language=Italian |journal=Minerva dietologica e gastroenterologica |volume=35 |issue=1 |pages=7–12 |year=1989 |pmid=2657497 |doi=] and eating disorders and there is some evidence that presence of a hiatal hernia is a predisposing condition.

Presentation

Mallory-Weiss syndrome often presents as an episode of vomiting up blood (hematemesis) after violent retching or vomiting, but may also be noticed as old blood in the stool (melena), and a history of retching may be absent.

In most cases, the bleeding stops spontaneously after 24-48 hours, but endoscopic or surgical treatment is sometimes required and rarely the condition is fatal.

Diagnosis

Definitive diagnosis is by endoscopy.

Treatment

Treatment is usually supportive as persistent bleeding is uncommon. However cauterization or injection of epinephrinecite journal |author=Gawrieh S, Shaker R |title=Treatment of actively bleeding Mallory-Weiss syndrome: epinephrine injection or band ligation? |journal=Current gastroenterology reports |volume=7 |issue=3 |pages=175 |year=2005 |pmid=15913474 |doi=] to stop the bleeding may be undertaken during the index endoscopy procedure.

Very rarely embolization of the arteries supplying the region may be required to stop the bleeding.

History

The condition was first described in 1929 by G. Kenneth Mallory and Soma Weiss in 15 alcoholic patients. [Weiss S, Mallory GK. "Lesions of the cardiac orifice of the stomach produced by vomiting." Journal of the American Medical Association 1932;98:1353-55.]

ee also

*Boerhaave syndrome
*Hematemesis

References

* [http://www.cecilmedicine.com/buy.cfm?book=goldman Cecil Textbook of Medicine]
* [http://www.oup.com/us/catalog/general/subject/Medicine/PrimaryCare/?ci=0192629220&view=usa The Oxford Textbook of Medicine]


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