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Mallory-Weiss tear

Definition

A Mallory-Weiss tear occurs in the mucus membrane of the lower part of the esophagus or upper part of the stomach, near where they join. The tear may bleed.

Alternative Names

Mucosal lacerations - gastroesophageal junction

Causes

Mallory-Weiss tears are most often caused by forceful or long-term vomiting or coughing. They may also be caused by epileptic convulsions.

Any condition that leads to violent and lengthy bouts of coughing or vomiting can cause these tears.

Symptoms

Symptoms may include:

Exams and Tests

Tests may include:

Treatment

The tear usually heals in a few days without treatment. The tear may also be fixed by clips that are put in during an EGD. Surgery is rarely needed. Drugs that suppress stomach acid (proton pump inhibitors or H2 blockers) may be given, but it is not clear if they are helpful.

If blood loss has been great, blood transfusions may be needed. In most cases, bleeding stops without treatment within a few hours.

Outlook (Prognosis)

Repeated bleeding is uncommon and the outcome is most often good. Cirrhosis of the liver and problems with blood clotting make future bleeding episodes more likely to occur.

Possible Complications

Hemorrhage (loss of blood)

When to Contact a Medical Professional

Call your health care provider if you begin vomiting blood or if you pass bloody stools.

Prevention

Treatments to relieve vomiting and coughing may reduce risk. Avoid excessive alcohol use.

Gallery

Digestive system
The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.
Digestive system
The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.
Stomach and stomach lining
The stomach connects the esophagus to the small intestines and is where the majority of food digestion takes place.

References

Falk GW, Katzka DA. Diseases of the esophagus. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 129.

Katzka DA. Esophageal disorders caused by medications, trauma, and infection. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 45.

Last reviewed October 27, 2020 by Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team..

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