Curriculum · Gastroenterology
Mallory-Weiss syndrome
What it is
Mallory-Weiss syndrome, also known as gastro-esophageal laceration syndrome, is a partial longitudinal mucosal tear in the mucosa. The tear sits at the GE junction, described as longitudinal mucosal lacerations, an intramural dissection, in the distal esophagus and proximal stomach. It is one cause of upper GI bleeding, meaning bleeding proximal to the ligament of Treitz. Four causes account for 80 per cent of upper GI bleeding: PUD, esophagogastric varices, esophagitis and Mallory-Weiss tear. In one table of causes of upper GI bleed in India it accounted for 10.8 per cent. In the etiology table for upper gastrointestinal bleeding it belongs to the arterial, nonvariceal group, together with peptic ulcer disease, hemorrhagic gastritis, neoplasm, inflammatory pseudoaneurysms, aortoduodenal fistula, iatrogenic injury, trauma, hemobilia and hemosuccus pancreaticus, set against a venous, variceal group of cirrhosis, Budd-Chiari syndrome and splenic vein thrombosis. A further list of causes of upper GI bleeding also names esophageal varices, AV malformation and Dieulafoy lesion.
Causes and risk
It is caused by severe alcoholism, forceful retching, coughing or vomiting. The risk factors named are alcohol use and hiatal hernia. Heavy alcohol use with retching before the hematemesis, hematemesis following weight lifting, and a young woman with bulimia are the three settings given.