Mallory-weiss tear

Question 1

What is it?

Answer 1

Mucosal lacerations in the upper GIT

Question 2

In which 2 areas do tears most commonly occur?

Answer 2

Gastro-oesophageal junction

OR

Gastric cardia

Question 3

What does a mallory-weiss tear cause?

Answer 3

Upper GI bleeding (UGIB) - haematemesis

Emergency

Question 4

When does haematemesis usually occur in someone with a tear?

Answer 4

After prolonged or forceful bouts of retching, vomiting, coughing, straining, hiccupping

Question 5

Give 3 RF

Answer 5

XS alcohol intake

Conditions that predispose to retching/vomiting: e.g.

• Gastroenteritis
• Hyperemesis gravidarum
• Bulimia - purging

Chronic cough

• COPD
• Whooping cough
• Bronchitis

Hiatus hernia

Question 6

How does it classically present?

Answer 6

Haematemesis following a bout of retching/ vomiting

Question 7

Name other SX that may occur

Answer 7

• Melaena
• Light-headed
• Dizzy/ syncope

Question 8

Which scoring system should be used to assess upper GI bleed?

Explain the score

Answer 8

The Rockall scoring system

<3 = excellent prognosis
8+ = extremely poor prognosis

Question 9

What is the primary diagnostic IX?

Answer 9

Endoscopy

Question 10

What are other IX necessary? (e.g. for UGIB)

Answer 10

FBC + haematocrit