Abstract
A clinical syndrome is described in 22 patients who present with epigastric pain alone or with hematemesis which is associated with a precedent history of recurrent early morning retching or postprandial retching. The characteristic endoscopic finding is a knuckle of inflamed and sometimes bleeding gastric mucosa which repeatedly prolapses into the esophageal lumen during retching. Other upper gastrointestinal lesions are not found. Retching is thought to cause the forceful prolapse and subsequent traumatization of gastric mucosa. The episodes of vigorous retching and resultant gastric trauma are now considered to be the cause of the abdominal pain and hematemesis, and it is proposed that this combination of clinical features illustrates a distinct syndrome which we have called prolapse gastropathy. This condition is a significant cause of hematemesis and abdominal pain in a group of nonalcoholic patients who demonstrate an unusual sensitivity to gag and retch.
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Mallory GK, Weiss S: Hemorrhages from lacerations of the cardiac orifice of the stomach due to vomiting. Am J Med Sci 178:506–515, 1929
Delumeau G, Perrin D, de Lisle LR, Veyrac Y, Miniconi P: Apport de la fibroscopie au diagnostic du syndrome de Mallory Weiss et des ulcerations haemorragiques de la jonction oeso-gastrique. Ann Gastroenterol Hepatol 8:329–337, 1972
Axon ATR, Clarke A: Haematemesis—a new syndrome? Br Med J 1:491–492, 1975
Young GP, Thomas R, Wall AJ: Retrograde gastric mucosal prolapse as a cause of haematemesis. Med J Aust 2:488–489, 1976
Laforet EG: Acute haemorrhagic infarction of prolapsed gastric mucosa. Gastroenterology 70:589–591, 1976
Avery Jones F, Gummer JW, Lennard-Jones JE: Clinical Gastroenterology. Blackwell Scientific Publication. Oxford, 1968, pp 15–19
Baker RW, Spiro AH, Trnka YM: Mallory Weiss tear complicating upper gastrointestinal endoscopy. Case reports and review of the literature. Gastroenterology 82:140–142, 1982
Thomas E, Khatak KG: Haemorrhage due to retrograde prolapse of the stomach. Am J Gastroenterol 71:477–480, 1979
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Shepherd, H.A., Harvey, J., Jackson, A. et al. Recurrent retching with gastric mucosal prolapse. Digest Dis Sci 29, 121–128 (1984). https://doi.org/10.1007/BF01317052
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DOI: https://doi.org/10.1007/BF01317052