Mallory-Weiss syndrome is a superficial tear (laceration) of the tissue where the lower esophagus and the upper part of the stomach meet.
The tear can be caused by forceful vomiting.
Symptoms include blood in vomit.
The diagnosis is based on upper endoscopy.
When needed, treatment includes measures to stop the bleeding.
The esophagus is the hollow tube that leads from the throat (pharynx) to the stomach. (See also Overview of the Esophagus and Overview of Esophageal Injuries.)
A Mallory-Weiss tear occurs during forceful vomiting, retching, or hiccups. The tear may rupture blood vessels, which then bleed (see also Gastrointestinal Bleeding).
Mallory-Weiss syndrome was initially described in people with an alcohol use disorder, but it can occur in anyone who vomits forcefully.
Photo provided by David M. Martin, MD.
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Symptoms of Mallory-Weiss Syndrome
The first symptom of Mallory-Weiss syndrome is usually the appearance of bright-red blood in vomit. Vomiting blood is called hematemesis.
Some people feel sharp pain in the lower chest when the esophagus tears during vomiting.
Diagnosis of Mallory-Weiss Syndrome
Upper endoscopy
Doctors suspect the diagnosis of Mallory-Weiss syndrome in people who have blood in their vomit after one or more episodes of vomiting. If the amount of bleeding is small, doctors may wait to do testing because the bleeding may stop on its own.
If the bleeding is severe or does not stop on its own, doctors do upper endoscopy. During upper endoscopy, doctors examine the esophagus using a flexible tube called an endoscope. Upper endoscopy allows doctors to see the bleeding source and often treat it at the same time.
Treatment of Mallory-Weiss Syndrome
Measures to stop the bleeding
Most bleeding episodes stop by themselves, but sometimes the doctor must do endoscopy and take measures to stop the bleeding. Measures include using heat to cauterize the bleeding blood vessel, clipping it closed, or injecting a medication into it.
People who lose a lot of blood require a blood transfusion.
Surgery to repair the tear is rarely required.
