Mallory-Weiss Syndrome

ByKristle Lee Lynch, MD, Perelman School of Medicine at The University of Pennsylvania
Reviewed/Revised Feb 2024
View Patient Education

Mallory-Weiss syndrome is a nonpenetrating mucosal laceration of the distal esophagus and proximal stomach caused by vomiting, retching, or hiccuping.

(See also Overview of Esophageal and Swallowing Disorders.)

Initially described in patients with alcohol use disorder, Mallory-Weiss syndrome can occur in any patient who vomits forcefully. It is the cause of approximately 5 to 10% of episodes of upper gastrointestinal (GI) hemorrhage (1).

The tear may also be accompanied by pain in the lower chest.

Reference

  1. 1. Knoblauch M, Stevka E, Lämmli J, et al: The Mallory-Weiss-syndrome: a clinical study of 20 cases. Endoscopy 8(1):5-9, 1976. doi: 10.1055/s-0028-1098366

Diagnosis of Mallory-Weiss Syndrome

  • Upper endoscopy

Diagnosis of Mallory-Weiss syndrome is suggested clinically by a typical history of hematemesis occurring after 1 or more episodes of non-bloody vomiting. In such cases, if the amount of bleeding is minimal and the patient is stable, testing may be deferred and some patients can be discharged home.

Otherwise, if history is unclear or bleeding is ongoing, the patient should have standard evaluation for GI bleeding, typically with upper endoscopy and laboratory testing. Upper endoscopy can also be therapeutic because a clip can be placed over the tear to control bleeding.

Treatment of Mallory-Weiss Syndrome

  • Measures to stop the bleeding

Surgical repair is rarely required.

quizzes_lightbulb_red
Test your KnowledgeTake a Quiz!
Download the free MSD Manual App iOS ANDROID
Download the free MSD Manual App iOS ANDROID
Download the free MSD Manual App iOS ANDROID