Review article

Mallory-Weiss syndrome as a cause of upper gastrointestinal bleeding

Ivana Bonacin ; Klinički bolnički centar "Sestre milosrdnice", Klinika za unutarnje bolesti, Zavod za gastroenterologiju i hepatologiju
Dražen Zekanović ; Opća bolnica Zadar, Služba za internu medicinu, Sveučilište u Zadru, Odjel za zdravstvene studije
Jadranko Turčinov ; Opća bolnica Zadar, Služba za internu medicinu,
Neven Ljubičić ; Klinički bolnički centar "Sestre milosrdnice", Klinika za unutarnje bolesti, Zavod za gastroenterologiju i hepatologiju

Abstract

The Mallory-Weiss syndrome is a pathological condition where an acute increase in intragastric pressure causes mucosal laceration in the distal esophagus and stomach cardia. Presenting symptoms include hematemesis with or without melena and, in more severe cases, signs of hypovolemic shock (syncope, tachycardia, hypotension). The Mallory-Weiss syndrome causes 5-15% of all cases of upper gastrointestinal bleeding. Affected individuals are mostly middle-aged men with a history of alcohol consumption. Endoscopic finding of longitudinal lacerations, predominantly on the right esophageal wall and cardia, confirms the diagnosis. In most cases the bleeding stops spontaneously. Elderly patients or those with comorbidities often require endoscopic treatment such as epinephrine injection therapy, electrocoagulation, hemoclip placement or endoscopic band ligation to stop the bleeding. Only one or a combination of the several mentioned methods can be applied. Predictive factors for rebleeding are shock at initial presentation, active bleeding at initial endoscopy, coagulopathy and low hematocrit. Considered that bleeding Mallory-Weiss tears often present themselves in elderly patients with comorbidities, the risk for an unfavorable outcome is the same as in bleeding peptic ulcer and the mortality rate is around 5%.

Keywords

Mallory-Weiss syndrome; upper gastrointestinal bleeding; endoscopy

Hrčak ID:

177966

URI

https://hrcak.srce.hr/177966

Publication date:

20.3.2017.

Article data in other languages: croatian

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