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Mallory-Weiss Syndrome

  1. Vigorous vomiting produces upper gastrointestinal bleeding due to Vertical mucosal tear just below the esophago-gastric junction at the cardia in 90% of cases- (PGI Dec 97)
  2. Forceful vomiting may lead to either disease, but in Boerhaave's syndrome, the tear extends through all layers of the esophageal wall and above GE junction.
  3. Mallory Weiss syndrome seen in alcoholic (PGI Dec 99)
  4. Usually the bleeding is not severe and most of the cases managed by conservative treatment (90%).Q
  5. Endoscopic sclerotherapy or angiographic techniques (embolization) require if conservative treatment failed.
  6. If endoscopic therapy failed then required exploratory laparotomy and ligation of bleeding vessels.
  7. Sengstaken-Blakemore tube is not effective in MW tearQ because source bleeding in MW tear is arterial, should be avoided as it recreates & may further widen the tear.  
  8. Investigation of choice: EndoscopyQ
  9. Usual location of tear is just below the gastroesophageal junction of the lesser curvature of stomach between 2 & 6 O’clock on endoscopy , viewing patient in left lateral decubitus position.


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