Mallory-Weiss Tear

Question 1

Define Mallory-Weiss tear?

Answer 1

Tearing of the lining of the oesophagus around the junction with the stomach as a result of violent vomiting or straining to vomit

Question 2

What is the aetiology of Mallory-Weiss tears?

Answer 2

Caused by prolonged violent vomiting

Question 3

What are the risk factors for Mallory-Weiss tears?

Answer 3

Chronic alcohol abuse
Bulimia
Other causes: trauma, intense coughing, gastritis

Question 4

What is the epidemiology of Mallory-Weiss tears?

Answer 4

Quite rare

Question 5

What are the presenting symptoms of Mallory-Weiss tears?

Answer 5

Most cases don't cause any symptoms 
Abdominal pain 
Severe vomiting 
Haematemesis 
Involuntary retching 
Black/tarry sttols 
Symptoms of hypovolaemia if SEVERE blood loss (e.g. light-headedness)

Question 6

What is another sign of Mallory-Weiss tears?

Answer 6

Melaena

Question 7

What investigations do you do for Mallory-Weiss tears?

Answer 7

OGD

Bloods - FBC to check for anaemia

Question 8

What is the management plan for Mallory-Weiss tears?

Answer 8

80-90% of the time, the bleeding from a Mallory-Weiss tear will stop on its own
Surgery may be necessary if the bleeding doesn’t stop
Transfusions may be required if blood loss has been severe
Anti-reflux medications may also be prescribed

Question 9

What surgery coild you do for Mallory-Weiss tears?

Answer 9

Injection Sclerotherapy
Coagulation therapy
Arteriography

Question 10

What complications are there of Mallory-Weiss tears?

Answer 10

Boerhaave’s perforation

Question 11

What is the prognosis for patients with Mallory-Weiss tears?

Answer 11

GOOD prognosis