Mallory Weiss tear - Disorders of the oesophagus

Mallory-Weiss tear

Definition

A tear in the mucosa normally at or just above the oesophageal gastric junction.

Aetiology/pathophysiology

The tear in the mucosa is a result of a sudden increase in intra abdominal pressure associated with vomiting, particularly on a full stomach or after large amounts of alcohol.

Clinical features

Patients present with haematemesis which is usually small. The bleeding typically occurs after a number of retches, i.e. not on the first vomit.

Investigations

Young patients with a typical history do not require investigation. Other patients with an upper gastrointestinal bleed require endoscopy to confirm the diagnosis and exclude oesophageal varices.

Management

Almost all stop spontaneously. Continuing bleeding suggests other causes.