Mallory Weiss tear

Question 1

Define:

Answer 1

A tear in the squmaous lining of the oesophagus at the junction where the oesophagus meets the stomach. Caused by violent vomiting or straining to vomit.

Question 2

Aetiology:

Answer 2

Caused by prolonged violent vomiting

Question 3

Risk factors:

Answer 3

Bulimia

Chronic alcohol abuse

Trauma

Intense coughing

Gastritis

Question 4

Symptoms:

Answer 4

Usually have none

Violent vomiting

Haemetemesis

Abdo pain

Black tarry stools

Involuntary retching

Hypovalemia signs (light headed)

Question 5

Signs:

Answer 5

malena

Same as symps

Question 6

Investigations:

Answer 6

OGD

Bloods - FBC to investigate anemia

Question 7

Epidemiology:

Answer 7

quite rare

Question 8

Management:

Answer 8

80-90% will resolve on their own

If the bleeding does not stop:
Injection sclerotherapy
Coagulation therapy
Arteriography

Anti-reflux medication

Transfusions for large blood loss

Question 9

Complications:

Answer 9

Boerhaave’s perforation - spontaneous perforation of the oesophagus.

Sudden onset chest pain following vomiting.

SOB and pleuritic pain

Pleural effusion signs (stoney dull percussion, absent breath sounds and reduced vocal resonance), fever, tachycardia, hypotension,sweating and abdo rigidity)

Question 10

Prognosis:

Answer 10

Good as usually self limiting