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Mallory–Weiss syndrome is a condition where high intra-abdominal pressures causes laceration and bleeding of the mucosa called Mallory-Weiss tears. [1] Additionally, Mallory–Weiss syndrome is one of the most common causes of acute upper gastrointestinal bleeding, counting of around 1-15% of all cases in adults and less than 5% in children.
In 1929, Mallory and Soma Weiss, a physician at Harvard, reported on 15 cases of severe, painless hemorrhage caused by a tear in the mucosa of the esophagus or gastroesophageal junction preceded by vomiting in alcoholic patients. [3] They reported a further six cases in 1932. [4] This syndrome has become known as Mallory–Weiss syndrome.
[3] [4] A related condition is Mallory-Weiss syndrome which is only a mucosal tear. A common site of iatrogenic perforation is the cervical esophagus just above the upper sphincter, whereas spontaneous rupture as seen in Boerhaave syndrome perforation commonly occurs in the lower third of the esophagus. [5]
Mallory-Weiss tear; Gastric causes: Gastric ulcer; Gastric cancer; Gastritis; Gastric varices; Gastric antral vascular ectasia; Dieulafoy's lesions; Duodenal causes: Duodenal ulcer; Vascular malformation, including aorto-enteric fistulae. Fistulae are usually secondary to prior vascular surgery and usually occur at the proximal anastomosis at ...
Asclepiades of Ephesus was an ancient Roman man who possibly died of a digestive hemorrhage due to high amounts of alcohol intake, possibly because a doctor prescribed alcohol as medication. Alternatively, binge-drinking may have induced Mallory-Weiss Syndrome, which is bleeding from the mucosa in the stomach and esophagus. [6]
Mallory–Weiss syndrome: bleeding tears in the esophagal mucosa, usually caused by prolonged and vigorous retching. [4] Vomiting of ingested blood after bleeding in the mouth, nose, or throat. [4] Tumors of the stomach or esophagus. [4] Irritation or erosion of the lining of the esophagus or stomach. Radiation poisoning. Viral hemorrhagic fevers.
Other causes include Mallory-Weiss tears, cancer, and angiodysplasia. [2] A number of medications are found to cause upper GI bleeds. [16] NSAIDs or COX-2 inhibitors increase the risk about fourfold. [16] SSRIs, corticosteroids, and anticoagulants may also increase the risk. [16] The risk with dabigatran is 30% greater than that with warfarin. [17]
Repeated or profuse vomiting may cause erosions to the esophagus or small tears in the esophageal mucosa (Mallory–Weiss tear). This may become apparent if fresh red blood is mixed with vomit after several episodes.