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

Aetiology of Mallory-Weiss tear

Answer 2

Caused by prolonged violent vomiting

Question 3

Risk factors for Mallory-Weiss tear

2 + 3

Answer 3

Chronic alcohol abuse
Bulimia

Trauma
Intense coughing
Gastritis

Question 4

Epidemiology of Mallory-Weiss tear

prevalence

Answer 4

Quite rare

Question 5

Presenting symptoms of Mallory-Weiss tear

general + 6

Answer 5

Most cases don’t cause symptoms

Abdo pain
Severe vomiting
Haematemesis
Involuntary retching
Black/tarry stools
Symptoms of hypovolaemia if SEVERE blood loss

Question 6

Signs of Mallory-Weiss tear on physical examination

2

Answer 6

Melaena

Symptoms

Question 7

Investigations for Mallory-Weiss tear

2

Answer 7

OGD

Bloods

Question 8

Management of Mallory-Weiss tear

general + 3

Answer 8

80-90% of bleeding from Mallory-Weiss tear stops on its own

If bleeding does not stop…
Surgery may be necessary
injection sclerotherapy
coagulation therapy
arteriography
Transfusion if blood loss severe
Anti reflux medications may be prescribed

Question 9

Complications of Mallory-Weiss tear

1

Answer 9

Boerhaave’s perforation

Question 10

Prognosis of Mallory-Weiss tear

Answer 10

Good