A Mallory Weiss tear occurs due to violent projection of gastric contents against the lower esophagus which results in mucosal + submucosal tear with involvement of the venous plexus.
Patients present with massive painless haematemesis.
Tears most commonly involve the distal esophagus at the gastro-esophageal junction. It is more common in alcoholics with repeated episodes of vomiting.
On a Barium swallow study, there may be an incomplete leak of Barium.
A mucosal laceration without transmural perforation is likely to be occult on CT. However, CT images of the esophagus many occasionally show evidence of haemorrhage or foci of extraluminal gas at a site of mucosal injury 2.
Treatment and prognosis
Unless there is persisting bleeding, the treatment like that of other mucosal lacerations, is supportive 2. Most patients with upper gastrointestinal hemorrhage from a Mallory-Weiss tear cease bleeding spontaneously and do not require specific therapy 3.
- Boerhaave syndrome : in which there is no haematemesis as there is complete transmural disruption of the oesophageal wall with blood escaping into the mediastinum
It is named after G. Kenneth Mallory, American (US) Pathologist (1900 -1986) and Soma Weiss, American (US) Physician (1898 - 1942)1
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- 1. Kanne JP, Rohrmann CA, Lichtenstein JE. Eponyms in radiology of the digestive tract: historical perspectives and imaging appearances. Part I. Pharynx, esophagus, stomach, and intestine. Radiographics. 26 (1): 129-42. doi:10.1148/rg.261055084 - Pubmed citation
- 2. Young CA, Menias CO, Bhalla S et-al. CT features of esophageal emergencies. Radiographics. 2008;28 (6): 1541-53. doi:10.1148/rg.286085520 - Pubmed citation
- 3. Fisher RG, Schwartz JT, Graham DY. Angiotherapy with Mallory-Weiss tear. AJR Am J Roentgenol. 1980;134 (4): 679-84. AJR Am J Roentgenol (abstract) - Pubmed citation
- 4. Butler ML. Radiologic diagnosis of Mallory-Weiss syndrome. Br J Radiol. 1973;46 (547): 553-4. doi:10.1259/0007-1285-46-547-553 - Pubmed citation
Synonyms & Alternative Spellings
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