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Mallory-Weiss Tear

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Mallory-Weiss syndrome or Mallory-Weiss lesion



  • The tube that carries food from the mouth to the stomach is called the esophagus.  Tears (torn tissue) or cuts can form in the esophageal surface layer from certain conditions.  These tears are dangerous and may result in excessive bleeding.

  • Excessive vomiting or retching, although one quarter of patients with Mallory Weiss tears have no prior history of vomiting

  • Vomiting of blood, often following prolonged or forceful vomiting or retching.
  • One quarter of patients with Mallory-Weiss tears have no prior history of vomiting.

  • The diagnosis is always made by an endoscopy test (inserting a small camera at the tip of a long plastic tube), done usually by a gasteroenterologist, allowing the physician to see the tears.

  • Conditions that cause excessive vomiting:
    1. Alcoholism
    2. Pregnancy
    3. Bulimia (patient forces himself to vomit after each meal)

  • Blood transfusion
  • The majority of bleedings stop with conservative therapy in the hospital.
  • Putting the patient on intravenous fluids until the bleeding stops
  • Liquid diet after bleeding stops, gradually advancing to solids
  • Avoiding alcohol and certain other drugs that cause more bleeding 
  • Medications to decrease vomiting are often prescribed.
  • The bleeding can also be stopped during endoscopy using electro-coagulation (i.e., heating and burning the tear until it forms a scar), or by injecting medications such as epinephrine.
  • 5% of cases require surgery for uncontrolled bleeding.  Surgery is also indicated when conservative therapy fails.

  • This is a true emergency and you must seek immediate medical attention by calling 911.  Delay in treatment can be fatal.

  • Bleeding ulcers (i.e., damaged areas) of the stomach or the esophagus
  • Enlarged abnormal veins (in the esophagus) called varices




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