Mallory-Weiss syndrome
Mallory-Weiss syndrome is an upper-GI bleed from a longitudinal mucosal tear at the gastro-oesophageal junction, classically causing haematemesis after forceful vomiting or retching; most tears stop spontaneously, but the patient still needs acute upper-GI-bleed risk assessment.
Definition
Mallory-Weiss syndrome is acute upper gastrointestinal bleeding from a longitudinal mucosal laceration at or near the gastro-oesophageal junction, usually after forceful vomiting or retching. The tear does not involve the full thickness of the oesophageal wall, distinguishing it from Boerhaave syndrome.
First principles
The sequence is the clue
A sudden pressure rise during repeated vomiting, retching, coughing or straining can split the mucosa at the gastro-oesophageal junction. The classic history is non-bloody vomiting first, followed by fresh or coffee-ground haematemesis. The tear is superficial, so it is usually less dangerous than a full-thickness oesophageal rupture.
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