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A tear in the mucosa normally at or just above the oesophageal gastric junction.
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.
Patients present with haematemesis which is usually small. The bleeding typically occurs after a number of retches, i.e. not on the first vomit.
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.
Almost all stop spontaneously. Continuing bleeding suggests other causes.
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