This syndrome occurs after tears are formed in the mucosa and submucosa of the gastroesophageal junction, leading to bleeding. These tears do not occur in the muscular layer, like in Boerhaave syndrome.
The tears in Mallory-Weiss syndrome occur as a consequence of forceful vomiting and violent retching, which increases esophageal pressure. Conditions such as alcoholism, hyperemesis gravidarum and eating disorders, which lead to increased vomiting frequency can cause this syndrome.
Patients with alcoholism are at risk for developing this syndrome. As patients are more intoxicated, they may vomit more often, which can cause these tears.
Patients with eating disorders, such as bulimia nervosa, who regularly vomit forcefully may develop such tears.
A common symptom which may clue-in a provider to this condition is hematemesis. Patients may present with an episode of vomiting up blood, and may have a history of retching.
Diagnosis of the mucosal tears from Mallory-Weiss syndrome can be made through endoscopy. Treatment is usually supportive, but in severe bleeds cauterization or epinephrine injection may also be done during endoscopy.
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