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The mallory-weiss syndrome: Evaluation by early endoscopy of its clinical picture and its incidence in upper gastrointestinal hemorrhage

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Summary

1. In a prospective study of upper gastrointestinal hemorrhage, 297 cases were examined endoscopically. Eight instances of gastric or esophageal tears were noted. Over the 29-month period during which the study was carried out, there were 49,760 admissions to this municipal teaching hospital. The incidence of gastroesophageal tears was 2.7% of all upper gastrointestinal bleeders and 0.016% of all admissions.

2. Early endoscopy was of great value in establishing a rapid and accurate diagnosis of the lesion.

3. In 2 instances bleeding did not result from the demonstrated tears, but was due to coexistent acute gastric erosions.

4. In 4 other cases, bleeding from the tear stopped spontaneously; one of these was operated electively for a nonbleeding duodenal ulcer. Surgical intervention for continued bleeding was necessary in 2 patients, one of whom died.

5. An initial conservative approach to therapy of the Mallory-Weiss syndrome is suggested, provided the diagnosis is ascertained by early esophagogastroscopy. Continued bleeding will obviously dictate surgical intervention.

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Author information

Authors and Affiliations

  1. From the Section of Gastroenterology, Department of Medicine, and the Department of Surgery, New York Medical College-Metropolitan Hospital Medical Center, New York, N. Y.

    David Katz M.D., Moshe Freud M.D. & William M. P. McKinnon M.D.

Authors
  1. David Katz M.D.
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  2. Moshe Freud M.D.
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  3. William M. P. McKinnon M.D.
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Additional information

Supported in part by Training Grant TI-AM-5237-01 from the National Institute of Arthritis and Metabolic Disease, N.I.H., U. S. Public Health Service, and Contract U-1373 from the Health Research Council of the City of New York.

U. S. Public Health Service Trainee in Gastroenterology. Present address: Beilinson Hospital, Petah Tikvah, Israel.

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Katz, D., Freud, M. & McKinnon, W.M.P. The mallory-weiss syndrome: Evaluation by early endoscopy of its clinical picture and its incidence in upper gastrointestinal hemorrhage. Digest Dis Sci 10, 314–323 (1965). https://doi.org/10.1007/BF02233423

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