Gastroenterology Made Simple : Mallory Weiss Syndrome

Mallory Weiss Syndrome

This term refers to acute upper GI bleed as a result of a longitudinal tear in the mucosa of distal oesophagus or proximal part of the stomach.

Usually,it preceeds a history of retching or vomiting prior to the episode of Upper GI Bleed.

Associated / Predisposing Factors:

It is associated with condition causing a sudden and repeated rise in intra-abdominal pressure.

Common precipitating factors include:

Repeated retching / vomiting

Excessive alcohol abuse

Frequent hiccups/coughing

Old age

Presence of hiatus Hernia

Management:

Upper GI Endoscopy to evaluate the cause and to implement therapeutic intervention and assess the damage is usually mandatory.

Prognosis:

Prognosis is usually good.

Bleeding is mild and self limited and most lesions heal with conservative treatment.

PPIs/Proton Pump Inhibitors are given to all patients to promote healing

Boerhaave”s Syndrome:

This is a term that refers to rupture/perforation of esophagus along with air in mediastinum (pneumomediastinum)

This is an acute emergency.

Clinical Features:

Patients will present with severe chest pain and pain in abdomen.

There would be clinical findings of haemodynamic compromise (Low blood pressure,Tachycardia)

Investigations:

An urgent Chest X-ray lateral and PA views will show pneumo-mediastinum

Management:

This condition requires immediate emergency surgery.