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Mallory-Weiss tear

Mucosal lacerations - gastroesophageal junction

 

A Mallory-Weiss tear occurs in the mucus membrane of the lower part of the esophagus or upper part of the stomach, near where they join. The tear may bleed.

Causes

 

Mallory-Weiss tears are most often caused by forceful or long-term vomiting or coughing . They may also be caused by epileptic convulsions .

Any condition that leads to violent and lengthy bouts of coughing or vomiting can cause these tears.

 

Symptoms

 

Symptoms may include:

  • Bloody stools
  • Vomiting blood (bright red)

 

Exams and Tests

 

Tests may include:

  • CBC , possibly showing low hematocrit
  • Esophagogastroduodenoscopy (EGD), more likely to be done when there is active bleeding

 

Treatment

 

The tear usually heals in a few days without treatment. The tear may also be fixed by clips that are put in during an EGD. Surgery is rarely needed. Drugs that suppress stomach acid (proton pump inhibitors or H 2 blockers) may be given, but it is not clear if they are helpful.

If blood loss has been great, blood transfusions may be needed. In most cases, bleeding stops without treatment within a few hours.

 

Outlook (Prognosis)

 

Repeated bleeding is uncommon and the outcome is most often good. Cirrhosis of the liver and problems with blood clotting make future bleeding episodes more likely to occur.

 

Possible Complications

 

Hemorrhage (loss of blood)

 

When to Contact a Medical Professional

 

Call your health care provider if you begin vomiting blood or if you pass bloody stools.

 

Prevention

 

Treatments to relieve vomiting and coughing may reduce risk. Avoid excessive alcohol use .

 

 

Open References

References

Jensen DM. Gastrointestinal hemorrhage and occult gastrointestinal bleeding. In: Goldman L, Ausiello D, eds. Goldman-Cecil Medicine . 24th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 137.

Katzka DA. Esophageal disorders caused by medications, trauma, and infection. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease . 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 46.

Kovacs TO, Jensen DM. Gastrointestinal hemorrhage. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 135.

 
  • Digestive system

    Digestive system - illustration

    The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.

    Digestive system

    illustration

  • Mallory-Weiss tear

    Mallory-Weiss tear - illustration

    A Mallory-Weiss tear results from prolonged and forceful vomiting, coughing or convulsions. Typically the mucous membrane at the junction of the esophagus and the stomach develops lacerations which bleed, evident by bright red blood in vomitus, or bloody stools. It may occur as a result of excessive alcohol ingestion. This is an acute condition which usually resolves within 10 days without special treatment.

    Mallory-Weiss tear

    illustration

  • Stomach and stomach lining

    Stomach and stomach lining - illustration

    The stomach connects the esophagus to the small intestines and is where the majority of food digestion takes place.

    Stomach and stomach lining

    illustration

    • Digestive system

      Digestive system - illustration

      The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.

      Digestive system

      illustration

    • Mallory-Weiss tear

      Mallory-Weiss tear - illustration

      A Mallory-Weiss tear results from prolonged and forceful vomiting, coughing or convulsions. Typically the mucous membrane at the junction of the esophagus and the stomach develops lacerations which bleed, evident by bright red blood in vomitus, or bloody stools. It may occur as a result of excessive alcohol ingestion. This is an acute condition which usually resolves within 10 days without special treatment.

      Mallory-Weiss tear

      illustration

    • Stomach and stomach lining

      Stomach and stomach lining - illustration

      The stomach connects the esophagus to the small intestines and is where the majority of food digestion takes place.

      Stomach and stomach lining

      illustration

    Self Care

     

      Tests for Mallory-Weiss tear

       
         

        Review Date: 8/20/2016

        Reviewed By: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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