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Digestive system
Digestive system


Mallory-Weiss tear
Mallory-Weiss tear


Stomach and stomach lining
Stomach and stomach lining


Mallory-Weiss tear

Definition:

A Mallory-Weiss tear occurs in the mucus membrane of the lower part of the esophagus or upper part of the stomach, near where they join. The tear may bleed.



Alternative Names:

Mucosal lacerations - gastroesophageal junction



Causes, incidence, and risk factors:

Mallory-Weiss tears are usually caused by forceful or long-term vomiting or coughing . They may also be caused by epileptic convulsions , or anything else that increases the pressure inside the abdomen.

Any condition that leads to violent and lengthy bouts of coughing or vomiting can cause these tears.



Symptoms:

Signs and tests:

Treatment:

The tear usually heals in a few days without treatment. Surgery is rarely needed. Drugs that suppress stomach acid (proton pump inhibitors or H2 blockers) may be given, but it is not clear if they are helpful.

If blood loss has been great, blood transfusions may be needed. In most cases, bleeding stops without treatment within a few hours.



Support Groups:



Expectations (prognosis):

Repeated bleeding is uncommon and the outcome is usually good. Cirrhosis of the liver and problems with blood clotting make future bleeding episodes more likely to occur.



Complications:

Hemorrhage (loss of blood)



Calling your health care provider:

Call your health care provider if you begin vomiting blood or if you pass bloody stools.



Prevention:

Treatments to relieve vomiting and coughing may reduce risk. Avoid excessive alcohol use .



References:

Bjorkman DJ. Gastrointestinal hemorrhage and occult gastrointestinal bleeding. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 137.

Katzka DA. Esophageal disorders caused by medications, trauma, and infection. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier;2010:chap 45.




Review Date: 11/11/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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