Mallory-Weiss syndrome overview: Difference between revisions
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===Medical Therapy=== | ===Medical Therapy=== | ||
Treatment is usually supportive as persistent bleeding is uncommon. However [[cauterization]] or injection of [[epinephrine]]<ref name="pmid15913474">{{cite journal |author=Gawrieh S, Shaker R |title=Treatment of actively bleeding Mallory-Weiss syndrome: epinephrine injection or band ligation? |journal=Current gastroenterology reports |volume=7 |issue=3 |pages=175 |year=2005 |pmid=15913474 }}</ref> to stop the bleeding may be undertaken during the index endoscopy procedure. Very rarely [[embolization]] of the arteries supplying the region may be required to stop the bleeding. If all other methods fail, high [[gastrostomy]] can be used to ligate the bleeding vessel. It is to be noted that the tube will not be able to stop bleeding as here the bleeding is arterial and the pressure in the balloon is not sufficient to overcome the arterial pressure. | Treatment is usually supportive as persistent bleeding is uncommon. However [[cauterization]] or injection of [[epinephrine]]<ref name="pmid15913474">{{cite journal |author=Gawrieh S, Shaker R |title=Treatment of actively bleeding Mallory-Weiss syndrome: epinephrine injection or band ligation? |journal=Current gastroenterology reports |volume=7 |issue=3 |pages=175 |year=2005 |pmid=15913474 }}</ref> to stop the bleeding may be undertaken during the index endoscopy procedure. Very rarely [[embolization]] of the arteries supplying the region may be required to stop the bleeding. If all other methods fail, high [[gastrostomy]] can be used to ligate the bleeding vessel. It is to be noted that the tube will not be able to stop bleeding as here the bleeding is arterial and the pressure in the balloon is not sufficient to overcome the arterial pressure. | ||
===Surgery=== | |||
Surgical oversewing of the tear is reserved for the occasional bleeding case that is refractory to endoscopic therapy or angiotherapy. | |||
==References== | ==References== | ||
Revision as of 06:09, 22 February 2013
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Mallory-Weiss syndrome refers to bleeding from tears in the mucosa at the junction of the stomach and esophagus, usually caused by severe retching, coughing, or vomiting. It is often associated with alcoholism and eating disorders and there is some evidence that presence of a hiatal hernia is a required predisposing condition.
Historical Perspective
The condition was first described in 1929 by G. Kenneth Mallory and Soma Weiss in 15 alcoholic patients [1].
Causes
Mallory-Weiss syndrome is caused by severe retching, coughing, or vomiting. It is often associated with alcoholism and eating disorders and there is some evidence that presence of a hiatal hernia is a required predisposing condition.
Diagnosis
History and Symptoms
Mallory-Weiss syndrome often presents as an episode of vomiting up blood (hematemesis) after violent retching or vomiting, but may also be noticed as old blood in the stool (melena), and a history of retching may be absent. In most cases, the bleeding stops spontaneously after 24-48 hours, but endoscopic or surgical treatment is sometimes required and rarely the condition is fatal.
Endoscopy
Definitive diagnosis is by endoscopy.
Treatment
Medical Therapy
Treatment is usually supportive as persistent bleeding is uncommon. However cauterization or injection of epinephrine[2] to stop the bleeding may be undertaken during the index endoscopy procedure. Very rarely embolization of the arteries supplying the region may be required to stop the bleeding. If all other methods fail, high gastrostomy can be used to ligate the bleeding vessel. It is to be noted that the tube will not be able to stop bleeding as here the bleeding is arterial and the pressure in the balloon is not sufficient to overcome the arterial pressure.
Surgery
Surgical oversewing of the tear is reserved for the occasional bleeding case that is refractory to endoscopic therapy or angiotherapy.
References
- ↑ Weiss S, Mallory GK. Lesions of the cardiac orifice of the stomach produced by vomiting. Journal of the American Medical Association 1932;98:1353-55.
- ↑ Gawrieh S, Shaker R (2005). "Treatment of actively bleeding Mallory-Weiss syndrome: epinephrine injection or band ligation?". Current gastroenterology reports. 7 (3): 175. PMID 15913474.