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Laceração de Mallory-Weiss

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  • Visão geral
  • Teoria
  • Diagnóstico
  • Tratamento
  • ACOMPANHAMENTO
  • Recursos
Última revisão das evidências: 16 Feb 2026
Última atualização do tópico: 28 Jan 2025

Resumo

Definição

Anamnesis y examen

Principales factores de diagnóstico

  • hematêmese
Todos los datos

Otros factores de diagnóstico

  • vertigem/tontura
  • hipotensão postural/ortostática
  • disfagia
  • odinofagia
  • dor
  • melena
  • hematoquezia
  • choque
  • sinais de anemia
Todos los datos

Factores de riesgo

  • afecções que predispõem ao esforço para vomitar, vômitos e/ou esforços
  • tosse crônica
  • hérnia hiatal
  • esforço para vomitar durante endoscopia ou outra intervenção
  • consumo significativo de bebidas alcoólicas
  • instrumentação prévia
  • idade entre 30 e 50 anos
  • sexo masculino
  • uso de aspirina ou outros anti-inflamatórios não esteroidais
  • soluços
  • trauma abdominal contuso
  • ressuscitação cardiopulmonar
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • Hemograma completo
  • ureia
  • creatinina e eletrólitos
  • testes da função hepática
  • tempo de protrombina (TP)/razão normalizada internacional (INR)
  • tempo de tromboplastina parcial (TTP)
  • prova cruzada/tipagem sanguínea
  • endoscopia digestiva alta (EDA) flexível
Todos los datos

Pruebas diagnósticas que deben considerarse

  • tomografia computadorizada (TC) do tórax
  • radiografia torácica
  • angiografia
Todos los datos

Algoritmo de tratamiento

Agudo

todos os pacientes

Colaboradores

Autores

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

Professor of Medicine

Center Director

Center for Advanced Therapeutic Endoscopy (CATE)

Advent Health

Porter Adventist Hospital

Denver

CO

Divulgaciones

DGA is a consultant for Merit Medical, Cook Endoscopy, Olympus America, and Boston Scientific.

Agradecimientos

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

Divulgaciones

SR and JCM declare that they have no competing interests.

Revisores por pares

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.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Alali AA, Barkun AN. An update on the management of non-variceal upper gastrointestinal bleeding. Gastroenterol Rep (Oxf). 2023 Mar 20;11:goad011.Full text  Abstract

Laine L, Barkun AN, Saltzman JR, et al. ACG clinical guideline: upper gastrointestinal and ulcer bleeding. Am J Gastroenterol. 2021 May 1;116(5):899-917.Full text  Abstract

Barkun AN, Almadi M, Kuipers EJ, et al. Management of nonvariceal upper gastrointestinal bleeding: guideline recommendations from the International Consensus Group. Ann Intern Med. 2019 Dec 3;171(11):805-22.Full text  Abstract

American College of Radiology. ACR appropriateness criteria: nonvariceal upper gastrointestinal bleeding​. 2024 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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