Mallory-Weiss tear

Mallory-Weiss Tear (MWT) accounts for 3% to 15% of people with upper gastrointestinal (GI) bleed.

Commonly presents with hematemesis after an episode of forceful or recurrent retching, vomiting, coughing, or straining.

Definitive diagnosis is usually made by esophagogastroduodenoscopy.

MWT is mostly self limiting, so treatment is generally supportive. Emergency treatment is reserved for those showing signs or symptoms of instability.

First-line treatment in an actively bleeding patient is therapeutic endoscopy. Endoscopy can also help to rule out other causes of upper GI bleeding.

Rarely angiography with embolization of the arteries supplying the region, or surgical repair, may be required to control bleeding.

Mallory-Weiss tear (MWT), also known as Mallory-Weiss syndrome (MWS), is characterized by a tear or laceration often along the right border of, or near, the gastroesophageal junction. Patients present with nonvariceal upper gastrointestinal bleeding. The hemorrhage is usually self-limited, ceasing spontaneously in 80% to 90% of patients.[1]Sugawa C, Benishek D, Walt AJ. Mallory-Weiss syndrome: a study of 224 patients. Am J Surg. 1983;145:30-33. http://www.ncbi.nlm.nih.gov/pubmed/6600377?tool=bestpractice.com

The pathogenesis is not completely understood. However, most patients report an MWT after an event that provokes a sudden rise in the pressure gradient across the gastroesophageal junction, such as retching, vomiting, coughing, or straining.