Mallory-Weiss

Clinical

Mallory-Weiss tears occur when there is a sudden increase in intraesophageal pressure, therefore producing a linear mucosal laceration near the gastric cardia. Violent retching or vomiting after an alcohol binge often causes the tears. However, the tears can also be caused by prolonged hiccupping, coughing, seizures, childbirth, straining during defecation, blunt abdominal trauma, or direct laceration of the mucosa. Patients often present with abrupt onset of hematemesis. Most tears however will heal spontaneously after 48 to 72 hours. Therefore they are often managed conservatively, while some may require intra-arterial infusion of vasopressin, embolization, or surgical repair to control the bleeding. The overall mortality rate is only about 3%.

Radiological findings

Most Mallory-Weiss tears are diagnosed via endoscopy, but they may occasionally be found on double contrast esophagrams. The tears appear as shallow, linear 1 to 4cm collections of barium oriented longitudinally in the distal esophagus just above the gastroesophageal junction.