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Esophageal Laceration (Mallory-Weiss Syndrome)

(Mallory-Weiss Syndrome)

By Michael C. DiMarino, MD, Division of Gastroenterology and Hepatology, Department of Medicine, Thomas Jefferson University

An esophageal laceration (Mallory-Weiss syndrome) is a tear that does not penetrate the wall of the esophagus.

A laceration of the lower esophagus and the upper part of the stomach during forceful vomiting, retching, or hiccups is called a Mallory-Weiss tear. The tear may rupture blood vessels, which then bleed. Mallory-Weiss syndrome was initially described in alcoholics, but it can occur in anyone who vomits forcefully.

The first symptom is usually the appearance of blood in vomited material. Mallory-Weiss syndrome is the cause of about 5% of bleeding episodes in the upper digestive tract.

The diagnosis is made by esophagoscopy (see Endoscopy) or angiography (a catheter is used to inject an artery with a dye that can be seen on x-rays). The laceration cannot be seen on routine x-rays.

Most bleeding episodes stop by themselves, but sometimes the doctor must perform esophagoscopy and stop the bleeding by cauterizing the bleeding vessel or injecting a drug into it. Alternatively, the doctor may inject vasopressin or epinephrine during angiography to reduce blood flow into the bleeding vessel. People who lose a lot of blood require a transfusion. Surgical repair is rarely required.

Did You Know...

  • Forceful vomiting can tear the esophagus.

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