Mallory Weis Tear

Question 1

What is a Mallory Weiss tear

Answer 1

Oesophageal mucosal tear resulting in hematemesis

Question 2

what are the risk factors for MS tear

Answer 2

Usually to do with severe vomiting that increases intrabdominal pa causing lacerations:

Alcoholism - (MC - young male w/ hx of retching )
Pregnancies
Chronic cough (COPD,CF,ASTHMA)

Question 3

Presentation of Mallory Weiss tear

Answer 3

symptoms usually cease spontaneously and patients are generally haemodynamically stable
Haematemesis
Melaena

if severe - Sx of hypovolaemic shock

Question 4

DX - Mallory Weiss Tear

Answer 4

Rule out Varicies - No lung/liver involvment

2. Endoscopy - OGD
   oesophagogastroduodenoscopy
   then assess Rock all Score - Risk score for bleed after endoscopy

Question 5

treating mallory weiss tear

Answer 5

Upper GI endoscopy: diagnostic and therapeutic with one of the following suggested
Clipping +/- adrenaline
Thermal coagulation with adrenaline
Sclerotherapy with adrenaline

Question 6

Complication for Mallory Weiss tear

Answer 6

bvoerhaave’s syndrome, which is a spontaneous perforation of the oesophagus, usually due to vomiting, which ruptures all the layers of the oesophageal wall (transmural)

Question 7

Treating mallory weiss tear

Answer 7

1st line :
Upper GI endoscopy: diagnostic and therapeutic with one of the following suggested
- Clipping +/- adrenaline
- Thermal coagulation with adrenaline

then post endoscopy:
IV PPI Pantoprazole to reduce % rebleeding