Mallory-Weiss tear

Last reviewed: 9 Nov 2022
Last updated: 21 Jun 2022

Summary

Definition

History and exam

Key diagnostic factors

  • hematemesis
More key diagnostic factors

Other diagnostic factors

  • light-headedness/dizziness
  • postural/orthostatic hypotension
  • dysphagia
  • odynophagia
  • pain
  • melena
  • hematochezia
  • shock
  • signs of anemia
Other diagnostic factors

Risk factors

  • condition predisposing to retching, vomiting, and/or straining
  • chronic cough
  • hiatus hernia
  • retching during endoscopy or other instrumentation
  • significant alcohol use
  • previous instrumentation
  • age 30 to 50 years
  • male sex
  • aspirin or other nonsteroidal anti-inflammatory drug ingestion
  • hiccups
  • blunt abdominal trauma
  • cardiopulmonary resuscitation
More risk factors

Diagnostic investigations

1st investigations to order

  • complete blood count (CBC)
  • blood urea nitrogen (BUN)
  • liver function test (LFT)
  • prothrombin time/international normalized ratio (PT/INR)
  • partial thromboplastin time (PTT)
  • chest x-ray (CXR)
  • esophagogastroduodenoscopy (EGD)
  • cross matching/blood grouping
More 1st investigations to order

Investigations to consider

  • creatine kinase (CK)
  • creatine kinase-MB (CK-MB)
  • troponin
  • ECG
  • angiography
More investigations to consider

Treatment algorithm

ACUTE

all patients

Contributors

Authors

Douglas G. Adler, MD, FACG, AGAF, FASGE

Professor of Medicine

Division of Gastroenterology

Department of Internal Medicine

Huntsman Cancer Institute

University of Utah

Salt Lake City

UT

Disclosures

DGA is a consultant for BSC, Merit, Cook, and Olympus.

Acknowledgements

Dr Douglas Adler would like to gratefully acknowledge Dr Shilpa Reddy and Dr Juan Carlos Munoz, the previous contributors to this topic.

Disclosures

SR and JCM declare that they have no competing interests.

Peer reviewers

Joseph Sung, MD

Professor of Medicine

Department of Medicine and Therapeutics

Director

Institute of Digestive Disease

The Chinese University of Hong Kong

Hong Kong

Disclosures

JS declares that he has no competing interests.

Imtiyaz Mohammed, MD

Consultant Gastroenterologist

Sandwell General Hospital

Lyndon

West Bromwich

UK

Disclosures

IM declares that he has no competing interests.

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