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Mallory-Weiss tear

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 H2 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.

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.

Alternative Names

Mucosal lacerations – gastroesophageal junction

References

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.

See also  Asthma

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