Mallory-Weiss tear

Question 1

Pathophysiology of Mallory-Weiss tear (why is different from Boerhaave syndrome?)

Answer 1

Severe vomiting, retching or coughing causing mucosal/submucosal tear in the oesophagus.

Boerhaave involves whole thickness of oesophagus

Question 2

Risk factors for Mallory-Weiss tear

4

Answer 2

1. Alcoholism
2. Bulimia nervosa
3. Hiatus hernia
4. NSAID abuse

Question 3

Symptoms of Mallory-Weiss

2

Answer 3

1. Haematemesis after prolonged retching or vomiting
2. Melaena

NO PAIN

Question 4

Management of Mallory-Weiss

Answer 4

1. Supportive (self-resolving)

2. Ongoing bleeding: cauterisation, epinephrine injection, artery embolisation