Mallory Weiss Syndrome (Tear) : Causes, Symptoms, Diagnosis, Investigations, Treatment, Prognosis, & Prevention
Definition
- Mallory Weiss Syndrome (MWS) is a condition causing the longitudinal tear of partial thickness in the mucosa of stomach below the gastro-oesophageal junction (in 70% cases) due to barotrauma.
- It is usually seen in right side cardiac region.
- It is common in 1 o’ clock position.
Causes
- It is seen in adults with severe prolonged vomiting which cause barotrauma. Violent vomiting often may be due to migraine or vertigo or after alcoholic bout.
Risk Factors
Mallory Weiss Syndrome is common-
- During pregnancy,
- After alcoholic binge,
- Hiatus hernia.
Clinical Symptoms
- Vomiting → Tear → Haematemesis (Vomiting up blood) → Features of Shock
Investigations (Ix)
- Gastroscopy (Endoscopy) – Ix of choice
- Hb%
- PCV
- Blood grouping
Treatment (Rx)
1. Conservative (Supportive) Treatment
- Antiemetics
- IV Fluids
- Blood transfusion
- Sedation
- Haemostatic agents such as vasopressin
2. Endoscopic Injection Therapy (If required)
3. Surgery (Rarely required)
Prognosis
- Outcome: Good
Recurrence
- MWS may recur if risk factors are present.
Prevention
- Prevent or treat conditions which cause prolonged episodes of severe vomiting.
- Limit alcohol use to prevent recurrent mallory weiss syndrome.
- Treat cirrhosis to prevent recurrent mallory weiss syndrome.
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