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.
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 oesophagus 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.
History and etymology
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 dysmotility
- oesophageal tumours
- benign oesophageal neoplasms
- malignant oesophageal neoplasms
- gastro-oesophageal reflux disease
- oesophageal stricture
- 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