Mallory-Weiss Tear Flashcards
1
Q
Definition
A
Tearing of the lining of the oesophagus around the junction with the stomach as a result of violent vomiting or straining to vomit.
2
Q
Aetiology
A
Caused by prolonged violent vomiting
3
Q
Risk factors
A
o Chronic alcohol abuse
o Bulimia
o Other causes: trauma, intense coughing, gastritis
4
Q
Epidemiology
A
Quite rare
5
Q
Presenting symptoms
A
- Most cases do not cause any symptoms
- Abdominal pain
- Severe vomiting
- Haematemesis
- Involuntary retching
- Black/tarry stools
- Symptoms of hypovolaemia if SEVERE blood loss (e.g. light-headedness)
6
Q
Signs on physical examination
A
• Melaena
Plus presenting symptoms
7
Q
Investigations
A
- OGD
* Bloods - FBC to check for anaemia
8
Q
Management plan
A
• 80-90% of the time, the bleeding from a Mallory-Weiss
tear will stop on its own
• Surgery may be necessary if the bleeding does NOT stop
o Injection sclerotherapy
o Coagulation therapy
o Arteriography
- NOTE: transfusions may be required if blood loss has been severe
- Anti-reflux medications may also be prescribed
9
Q
Possible complications
A
Boerhaave’s perforation (perforation of the oesophagus)
10
Q
Prognosis
A
GOOD prognosis
