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Chen W, Zhu XN, Wang J, Zhu LL, Gan T, Yang JL. Risk factors for Mallory-Weiss Tear during endoscopic submucosal dissection of superficial esophageal neoplasms. World J Gastroenterol 2019; 25:5174-5184. [PMID: 31558865 PMCID: PMC6747285 DOI: 10.3748/wjg.v25.i34.5174] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 06/15/2019] [Accepted: 06/25/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Adverse events during endoscopic submucosal dissection (ESD) of superficial esophageal neoplasms, such as perforation and bleeding, have been well-documented. However, the Mallory-Weiss Tear (MWT) during esophageal ESD remains under investigation. AIM To investigate the incidence and risk factors of the MWT during esophageal ESD. METHODS From June 2014 to July 2017, patients with superficial esophageal neoplasms who received ESD in our institution were retrospectively analyzed. The clinicopathological characteristics of the patients were collected. Patients were divided into an MWT group and non-MWT group based on whether MWT occurred during ESD. The incidence of MWTs was determined, and the risk factors for MWT were then further explored. RESULTS A total of 337 patients with 373 lesions treated by ESD were analyzed. Twenty patients developed MWTs during ESD (5.4%). Multivariate analysis identified that female sex (OR = 5.36, 95%CI: 1.47-19.50, P = 0.011) and procedure time longer than 88.5 min (OR = 3.953, 95%CI: 1.497-10.417, P = 0.005) were independent risk factors for an MWT during ESD. The cutoff value of the procedure time for an MWT was 88.5 min (sensitivity, 65.0%; specificity, 70.8%). Seven of the MWT patients received endoscopic hemostasis. All patients recovered satisfactorily without surgery for the laceration. CONCLUSION The incidence of MWTs during esophageal ESD was much higher than expected. Although most cases have a benign course, fatal conditions may occur. We recommend inspection of the stomach during and after the ESD procedure for timely management in cases of bleeding MWTs or even perforation outside of the procedure region.
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Affiliation(s)
- Wei Chen
- Department of Gastroenterology and Hepatology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xiao-Nan Zhu
- Department of Gastroenterology and Hepatology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Jin Wang
- Department of Gastroenterology and Hepatology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Lin-Lin Zhu
- Department of Gastroenterology and Hepatology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Tao Gan
- Department of Gastroenterology and Hepatology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Jin-Lin Yang
- Department of Gastroenterology and Hepatology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
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Corral JE, Keihanian T, Kröner PT, Dauer R, Lukens FJ, Sussman DA. Mallory Weiss syndrome is not associated with hiatal hernia: a matched case-control study. Scand J Gastroenterol 2017; 52:462-464. [PMID: 28007004 DOI: 10.1080/00365521.2016.1267793] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND/OBJECTIVE Hiatal hernia is considered to be a predisposing factor to develop Mallory-Weiss Syndrome (MWS). No large case-control studies verifying this hypothesis have been conducted. METHODS We reviewed all esophagogastroduodenoscopies with findings of MWS (n = 2342) in a national database and compared with age and gender-matched controls (n = 9368). Demographics, endoscopic characteristics and presence of a hiatal hernia were compared between both groups. Average age was 56.7 ± 18.6 years, and 72.4% were male. RESULTS Hiatal hernia was more common in controls, and no significant difference was seen in a multivariate analysis. CONCLUSION Dynamic changes inducing mucosal tension are more relevant determinants to develop MWS than gastro-esophageal junction location alone.
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Affiliation(s)
- Juan E Corral
- a Division of Gastroenterology and Hepatology , Mayo Clinic , Jacksonville , FL , USA
| | - Tara Keihanian
- b Department of Medicine , University of Miami Miller School of Medicine - Jackson Memorial Hospital , Miami , FL , USA
| | - Paul T Kröner
- c Department of Medicine , Mount Sinai, St. Luke's, and Roosevelt Hospitals, Icahn School of Medicine at Mount Sinai , New York , NY , USA
| | - Ryan Dauer
- b Department of Medicine , University of Miami Miller School of Medicine - Jackson Memorial Hospital , Miami , FL , USA
| | - Frank J Lukens
- a Division of Gastroenterology and Hepatology , Mayo Clinic , Jacksonville , FL , USA
| | - Daniel A Sussman
- d Division of Gastroenterology, Department of Medicine , University of Miami Miller School of Medicine , Miami , FL , USA
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Gualtieri M, Olivero D, Costa Devoti C. Spontaneaous linear gastric tears in a cat. J Small Anim Pract 2015; 56:581-4. [PMID: 25703995 DOI: 10.1111/jsap.12335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 11/16/2014] [Accepted: 12/02/2014] [Indexed: 11/29/2022]
Abstract
An 11-year-old female cat presented for chronic vomiting. Endoscopy revealed an altered gastric mucosa and spontaneous formation of linear gastric tears during normal organ insufflations. The histopathological diagnosis was atrophic gastritis with Helicobacter pylori infection. Medical treatment permitted a complete resolution of clinical signs. The linear tears observed resembled gastric lesions rarely reported in humans, called "Mallory-Weiss syndrome". To the authors' knowledge this is the first report of spontaneous linear gastric tears in animals.
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Affiliation(s)
- M Gualtieri
- Department of Health, Animal Science and Food Safety - Section of Surgery, University of Milan, 20133 Milan, Italy
| | - D Olivero
- Clinical Analysis Laboratory, Milan, Italy
| | - C Costa Devoti
- Department of Health, Animal Science and Food Safety Milan, Faculty of Veterinary Medicine, University of Milan, 20133 Milan, Italy
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Abstract
Mallory-Weiss tears (MWTs) are mucosal lacerations caused by forceful retching and are typically located at the gastroesophageal junction. Reported cases of MWT with serious complications seen in esophagogastroduodenoscopy are limited. We report MWT in an 81-year-old woman who presented with gastric perforation by esophagogastroduodenoscopy. We discuss and indicate that hiatal hernia, atrophic gastritis and old age may be associated with the gastric perforation in comparison to typical tears occurring at the gastroesophageal junction.
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Affiliation(s)
- Ji Wan Kim
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Chan-Sup Shim
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Tae Yoon Lee
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Young Koog Cheon
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
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Non-variceal gastrointestinal bleeding in patients with liver cirrhosis: a review. Dig Dis Sci 2012; 57:2743-54. [PMID: 22661272 DOI: 10.1007/s10620-012-2229-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Accepted: 05/01/2012] [Indexed: 02/08/2023]
Abstract
BACKGROUND Non-variceal gastrointestinal (NVGI) bleeding in cirrhosis may be associated with life-threatening complications similar to variceal bleeding. AIM To review NVGI bleeding in cirrhosis. METHODS MEDLINE, Scopus, and ISI Web of Knowledge were searched, using the textwords "portal hypertensive gastropathy," "gastric vascular ectasia," "peptic ulcer," "Dieulafoy's," "Mallory-Weiss syndrome," "portal hypertensive enteropathy," "portal hypertensive colopathy," "hemorrhoids," and "cirrhosis." RESULTS Portal hypertensive gastropathy (PHG) and gastric vascular ectasia (GVE) are gastric lesions that most commonly present as chronic anemia; acute upper GI (UGI) bleeding is a rare manifestation. Management of PHG-related bleeding is mainly pharmacological, whereas endoscopic intervention is favored in GVE-related bleeding. Shunt therapies or more invasive techniques are restricted in refractory cases. Despite its high incidence in cirrhotic patients, peptic ulcer accounts for a relatively small proportion of UGI bleeding in this patient population. However, in contrary to general population, the pathogenetic role of Helicobacter pylori infection remains questionable. Finally, other causes of UGI bleeding include Dieulafoy's lesion, Mallory-Weiss syndrome, and portal hypertensive enteropathy. The most common non-variceal endoscopic findings reported in patients with lower gastrointestinal bleeding are portal hypertensive colopathy and hemorrhoids. However, the vast majority of studies are case reports and, therefore, the incidence, diagnosis, and risk of bleeding remain undefined. Endoscopic interventions, shunting procedures, and surgical techniques have been described in this setting. CONCLUSIONS The data on NVGI bleeding in liver cirrhosis are surprisingly scanty. Large, multicenter epidemiological studies are needed to better assess prevalence and incidence and, most importantly, randomized studies should be performed to evaluate the success rates of therapeutic algorithms.
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UCHIDA Y, SAKURAI Y, OGIWARA K, CHIYONOBU T, HIGUCHI B, TANAKA I, SHIMA M, YOSHIOKA A. Successful management of Mallory-Weiss syndrome in a haemophilia A patient with inhibitor by recombinant activated factor VII. Haemophilia 2008; 14:841-3. [DOI: 10.1111/j.1365-2516.2008.01752.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kortas DY, Haas LS, Simpson WG, Nickl NJ, Gates LK. Mallory-Weiss tear: predisposing factors and predictors of a complicated course. Am J Gastroenterol 2001; 96:2863-5. [PMID: 11693318 DOI: 10.1111/j.1572-0241.2001.04239.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Little has been published regarding predictors of a complicated course after Mallory-Weiss tear (MWT). The aims of this study were to identify risk factors for a Mallory-Weiss tear and factors predictive of a complicated course. METHODS At our university hospital, we searched a computerized endoscopy database. At our Veterans Affairs hospital we manually searched printed endoscopy reports. Proposed risk factors for MWT were: history of alcohol use, recent alcohol binge, nonbloody initial emesis, anticoagulation, other coagulopathy, nonsteroidal anti-inflammatory use, and hiatal hernia. Proposed predictors of a complicated course were: age, hematemesis, melena, hematochezia, visible vessel, adherent clot, active bleeding, multiple tears, other pathology at endoscopy, admission Hct, hypotension or orthostatic changes, and coagulopathy. A complicated course was defined on the basis of >6 U of blood transfused, rebleeding, angiography, surgery, or death. Predictors of a complicated course were evaluated using the Mann-Whitney U test or Fisher exact test. RESULTS A total of 73 cases were reviewed. The most common risk factor was alcohol use, which was found in 44% of cases. In all, 23% of patients had no risk factors. Of the patients, 17 (23%) had a complicated course. Patients with a complicated course had a lower admission Hct (p = 0.009) and active bleeding at initial endoscopy (p = 0.013). CONCLUSION The predictive value of active bleeding supports early endoscopy for stratification and intervention.
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Affiliation(s)
- D Y Kortas
- Division of Digestive Diseases and Nutrition, University of Kentucky Medical Center, Lexington, USA
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Braverman I, Sichel JY, Halimi P, Goldsher M, Kadari A. Complication of jet ventilation during microlaryngeal surgery. Ann Otol Rhinol Laryngol 1994; 103:624-7. [PMID: 8060056 DOI: 10.1177/000348949410300808] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Complications during jet ventilation for microlaryngoscopy, which is usually a relatively safe procedure, are rare. Those described have included hypoventilation, pneumothorax, pneumomediastinum, subcutaneous emphysema, pneumoperitoneum, and gastric distention. We describe herein a case of a life-threatening complication during jet ventilation with a Carden's tube that ended in laparotomy.
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Affiliation(s)
- I Braverman
- Department of Otolaryngology-Head and Neck Surgery, Hadassah University Hospital, Jerusalem, Israel
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Abstract
The approach to nonvariceal UGI bleeding has been reviewed. Therapeutic endoscopy has been shown to be superior to medical therapy in patients with an actively bleeding ulcer and those at high risk of rebleeding. Of endoscopic therapies available to the GI endoscopist, multipolar electrocoagulation, heater probe, and injection therapy are comparable in efficacy and safety.
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Affiliation(s)
- P K Gupta
- Department of Medicine, Georgetown University Medical Center, Washington, DC
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Abstract
We have carried out a retrospective review of 61 patients with Mallory-Weiss syndrome, 9 of whom underwent hemostatic injection treatment. At emergency endoscopy, 3 patients (5%) were actively bleeding and 6 (10%) had stigmata of recent hemorrhage. Fifty-two patients had a lesion of the cardia which was the suspected source of bleeding in 33 cases (54%). In the remaining 19 cases (31%) this site was not considered responsible because other sites of bleeding were present in the upper gastrointestinal tract. The 9 patients with active bleeding or stigmata of recent hemorrhage underwent injection treatment and the other 52 patients were treated with H2 antagonists. The low rebleed rate and the zero mortality recorded in this series indicate that endoscopy is the optimum method for diagnosis and treatment of patients with Mallory-Weiss syndrome.
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Affiliation(s)
- G Di Felice
- Department of Surgery, U.L.S.S. No. 3, Belluno, Italy
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Sato H, Takase S, Takada A. The association of esophageal hiatus hernia with Mallory-Weiss syndrome. GASTROENTEROLOGIA JAPONICA 1989; 24:233-8. [PMID: 2744343 DOI: 10.1007/bf02774319] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The incidence of esophageal hiatus hernia in Mallory-Weiss syndrome was analyzed from endoscopic findings in order to clarify the association with Mallory-Weiss syndrome. Hiatus hernia was diagnosed from findings of both esophagoscopy and gastroscopy. In 23 patients with Mallory-Weiss syndrome confirmed by endoscopy, hiatus hernia was found 21 cases (91.3%), in which 9 (39.1%) were definite hernias and 12 (52.2%) were minor hernias. In 80 control cases of various gastrointestinal diseases, definite hernia was found in 7 cases (8.8%), and minor hernia was found in 13 cases (16.2%). The incidence of hiatus hernia in Mallory-Weiss syndrome was thus significantly higher than that in the control group. The incidence of hiatus hernia evaluated only by esophageal findings was lower than that evaluated by combined findings from the gastric and esophageal directions. These results indicate that evaluation from the gastric direction is an essential procedure for the diagnosis of esophageal hiatus hernia and that hiatus hernia is one of the predisposing factors for the development of Mallory-Weiss syndrome.
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Affiliation(s)
- H Sato
- Department of Internal Medicine, Kanazawa Medical University, Ishikawa, Japan
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Abstract
With the increasing early use of endoscopy, Mallory-Weiss syndrome has been found to be the cause of upper gastrointestinal bleeding in 224 of 2,175 (10.3 percent) patients studied. Since Mallory-Weiss syndrome is a self-limiting disease in more than 90 percent of patients, conservative treatment, including multiple transfusion, electrocoagulation, and compression by a Sengstaken-Blakemore tube in descending order of use, is the treatment of choice, especially in the medically debilitated patient. The cirrhotic patient poses special difficulty and generally has a poor outcome no matter what the treatment. Prolapse of the stomach into the esophagus may be an etiologic factor in a small subgroup of patients.
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Lubicz S, Shafir M, Diamond S, Monosan R, Cohen C. Mallory-Weiss syndrome secondary to cis-platinum chemotherapy: an unusual complication. J Surg Oncol 1982; 20:247-9. [PMID: 7202084 DOI: 10.1002/jso.2930200413] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The Mallory-Weiss syndrome is a relatively infrequent cause of digestive tract bleeding and most cases have been described in alcoholics. Nonoperative management is frequently successful. We present here a case of sudden onset of wretching and vomiting after IV infusion of cis-platinum for recurrent carcinoma of the uterine cervix in which the patient had profuse hematemesis secondary to three posterior gastroesophageal tears requiring operative intervention after failure of nonsurgical management. This is an unusual complication of antineoplastic chemotherapy and its prevention is emphasize in this paper.
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Abstract
The records of patients treated for upper gastrointestinal bleeding from 1974 through 1978 were reviewed. Five percent of this group (69 patients) had bleeding due to the Mallory-Weiss syndrome. Only 36 percent of patients had a correct admitting diagnosis. Esophagogastroscopy proved the most reliable diagnostic tool, with 94 percent of 63 patients studied having the diagnosis of Mallory-Weiss laceration confirmed. Initial management was medical in all patients. Twenty-one patients (30 percent) required operative intervention. There was a good correlation between the transfusion requirement and the need for operation. There were two deaths in this series; both were considered preventable. The Mallory-Weiss syndrome is common. Esophagogastroscopy performed early can result in a diagnostic accuracy rate of greater than 90 percent. Aggressive nonsurgical therapy after early diagnosis should continue to reduce the role of operation in the treatment of this condition. However, if bleeding continues after initial medical management, or if bleeding continues after 1,500 ml of blood is required, then surgical therapy should be instituted without delay.
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Michel L, Serrano A, Malt RA. Mallory-Weiss syndrome. Evolution of diagnostic and therapeutic patterns over two decades. Ann Surg 1980; 192:716-21. [PMID: 7447523 PMCID: PMC1344969 DOI: 10.1097/00000658-198012000-00004] [Citation(s) in RCA: 95] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
During a 19-year period ending December 1978, we treated 40 patients with upper gastrointestinal bleeding secondary to the Mallory-Weiss syndrome. Thirty patients had the triad of vomiting, hematemesis and alcoholism. The presence of lacerations within the gastric cardia was associated with the presence of hiatal hernia (p = 0.03). Endoscopic examinations demonstrated 32 of 38 additional upper gastrointestinal lesions associated with the syndrome that could have been mistaken as the actual source of hemorrhage. During the second decade, as compared with the first decade, widespread use of fiberoptic esophagogastroscopy led to the identification of the bleeding lacerations in 71% of the patients (versus 47% in the first decade) and in 80% (versus 0% in the first decade) of the patients who required an operation to control the bleeding. Although there was a 7.5% mortality rate in the two decades, the incidence of operative treatment tended to decrease (42-24%; p = 0.13). More impressive were the decreases in transfusions (14 units to 5 units per patient) and in delays before surgery (38 hours to 17 hours) (p equal to 0.05). Improved endoscopic diagnosis facilitates prompt and economic treatment.
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Foster DN, Miloszewski K, Losowsky MS. Diagnosis of Mallory-Weiss lesions. A common cause of upper gastrointestinal bleeding. Lancet 1976; 1:483-4. [PMID: 74458 DOI: 10.1016/s0140-6736(76)90785-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Mallory-Weiss lesions were considered to be the source of bleeding 21 (13.4%) of 157 unselected patients admitted to a general medical unit because of suspected upper gastrointestinal haemorrhage over a period of 30 months. They represented 16.7% of the 126 patients in whom there was ultimately good evidence of upper gastrointestinal blood-loss. In the total series of 200 suspected bleeding episodes the incidence was 11.5%. It is suggested that endoscopy of the upper gastrointestinal tract, peformed as early as possible after resuscitation, enables the diagnosis of the Mallory-Weiss lesion to be made, shows that it is a relatively common source of haemorrhage, and establishes whether bleeding has stopped, thereby helping to identify patients who can be managed without transfusion and those who are likely to require surgery.
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Abstract
Of forty-four patients with the Mallory-Weiss syndrome, nine (20 per cent) had endoscopic evidence of small submucosal hematoma(s) lying in or adjacent to the region of the the tear. These small hematomas are believed to occur most commonly as a variant of the Mallory-Weiss lesion.
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Saylor JL, Tedesco FJ. Mallory-Weiss syndrome in perspective. THE AMERICAN JOURNAL OF DIGESTIVE DISEASES 1975; 20:1131-4. [PMID: 1200008 DOI: 10.1007/bf01070756] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Nineteen patients with the Mallory-Weiss lesion diagnosed by panendoscopy are presented. This represents 10.5% of 180 acute upper-gastrointestinal bleeders. Only 36.8% of these 19 patients had a history of heavy ethanol intake and 26% had hiatus hernias. In addition to the Mallory-Weiss lesion, abnormalities in 63% were noted on endoscopy. None of the patients required surgery for control of the bleeding. Two patients were treated with selective arterial-vasopressin infusion. The importance of a high index of suspicion for this lesion in spite of the lack of a classical alcoholic or recurrent retching history and the value of intensive medical therapy, including early panendoscopy, is emphasized.
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Abstract
Three patients presented with symptoms suggesting a Mallory-Weiss tear. Endoscopy showed a localized, clearly demarcated area of bright red mucosa near the gastro-oesophageal junction; this was thought to have arisen by retrograde intussusception of the stomach during vomiting or retching and may have caused the haemorrhage.
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St John DJ, Masterton JP, Yeomans ND, Dudley HA. The Mallory-Weiss syndrome. BRITISH MEDICAL JOURNAL 1974; 1:140-3. [PMID: 4544226 PMCID: PMC1632974 DOI: 10.1136/bmj.1.5899.140] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
A policy of immediate investigation of patients with haematemesis or melaena or both led to the diagnosis of the Mallory-Weiss syndrome in 16 out of 121 patients admitted to a combined medical-surgical unit over three and a half years. A typical history suggestive of the diagnosis was obtainable in only nine of the 16 patients, though recent alcohol intake was high in another four. All patients survived the episode. Establishment of the diagnosis by oesophagogastroscopy was of special benefit when surgery was needed for control of continuing blood loss, but it also simplified the subsequent medical management of those patients in whom bleeding stopped spontaneously. The incidence of 13.2% in this series suggests that the Mallory-Weiss syndrome may be a relatively common cause of upper gastrointestinal bleeding.
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Dill JE, Wells RF, Levy M. The Mallory-Weiss syndrome: some unusual presentations and a suggested new therapy. Gastrointest Endosc 1972; 18:157-8. [PMID: 5035175 DOI: 10.1016/s0016-5107(72)74063-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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