Accounts for 3% to 15% of cases of upper gastrointestinal (GI) bleed. Most occur after a sudden rise in abdominal pressure or transmural pressure gradient across the gastro-oesophageal junction. This induces a tear and subsequent GI bleeding.
Commonly presents with haematemesis after an episode of forceful or long-term retching, vomiting, coughing, or straining.
Definitive diagnosis is made by oesophagogastroduodenoscopy.
Treatment in general is supportive, as most cases are self-limited. Emergency treatment is reserved for those showing signs or symptoms of instability.
First-line treatment in an actively bleeding patient is therapeutic endoscopy. Endoscopy is probably the most sensitive and specific diagnostic test for Mallory-Weiss tear (MWT) and can also help to rule out other causes of upper GI bleeding.
In rare cases, angiography with embolisation of the arteries supplying the region or surgical repair may be required to control the bleeding.
Mallory-Weiss tear (MWT), also known as Mallory-Weiss syndrome (MWS), is characterised by a tear or laceration at or near the gastro-oesophageal junction. Patients present with non-variceal upper GI bleeding. The haemorrhage is usually self-limited, ceasing spontaneously in 80% to 90% of cases.  The pathogenesis is not completely understood. However, most cases described in the literature occurred after an event that provokes a sudden rise in the pressure gradient across the gastro-oesophageal junction, such as retching, vomiting, coughing, or straining.
Associate Professor of Medicine
JCM declares that he has no competing interests.
Dr Juan Carlos Munoz would like to gratefully acknowledge Dr Shilpa Reddy, the previous co-contributor to this monograph. SR declares that she has no competing interests.
Professor of Medicine
Department of Medicine and Therapeutics
Institute of Digestive Disease
The Chinese University of Hong Kong
JS declares that he has no competing interests.
Sandwell General Hospital
IM declares that he has no competing interests.
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