Mallory Weiss tear

Mallory Weiss tears occur due to violent projection of gastric contents against the lower oesophagus, which results in mucosal and submucosal tear with involvement of the venous plexus. 

Patients present with massive painless haematemesis.

Tears most commonly involve the distal oesophagus at the gastro-eosophageal junction. It is more common in alcoholics with repeated episodes of vomiting.

Fluoroscopy

On a barium swallow study, there may be an incomplete leak of barium.

CT

A mucosal laceration without transmural perforation is likely to be occult on CT. However, CT images of the oesophagus many occasionally show evidence of haemorrhage or foci of extraluminal gas at a site of mucosal injury 2.

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.

It is named after G. Kenneth Mallory, United States of America, pathologist (1900-86) and Soma Weiss, United States of America, physician (1898-1942) 1.

  • Boerhaave syndrome: no haematemesis as there is complete transmural disruption of the oesophageal wall with blood escaping into the mediastinum
Oesophageal pathology
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Article information

rID: 17379
Sections: Signs, Pathology
Tag: cases
Synonyms or Alternate Spellings:
  • Mallory Weiss syndrome
  • Mallory-Weiss tear
  • Mallory-Weiss syndrome

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