Mallory-Weiss Syndrome A Changing Clinical Picture

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Abstract
A retrospective study of 18 episodes of upper gastrointestinal (UGI) bleeding secondary to Mallory-Weiss syndrome occurring in 16 patients is presented. Reported cases published since 1969 were summarized and compared with earlier collected series. The clinical spectrum, prognosis and opinion regarding etiology and treatment of the syndrome have changed in the last decade. Increased awareness of gastroesophageal lacerations secondary to emesis, other causes of significantly increased intraesophagogastric pressures and widespread utilization of fiberoptic endoscopy have resulted in identification of Mallory-Weiss syndrome with increasing frequency. Less severe lacerations which are healing with medical therapy are being recognized. Endoscopy should be performed in all cases of UGI hemorrhage and patients with Mallory-Weiss syndrome should be managed medically unless hemorrhage is massive or persistent, since nearly 3 of 4 patients can be successfully treated without surgery.

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