Mallory-Weiss tear

Definition

A Mallory-Weiss tear occurs in the mucous membrane where the esophagus connects to the stomach. The tear causes bleeding.

Alternative Names

Causes

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

The tear may be followed by vomiting bright red blood or by passing blood in the stool. Any condition that leads to violent and lengthy bouts of coughing or vomiting can cause these tears.

The incidence is 4 in 100,000 people.

Symptoms

• Vomiting blood (bright red)
• Bloody stools

Exams and Tests

• EGD (esophagogastroduodenoscopy) showing a tear with bleeding
• CBC possibly showing low hematocrit

Treatment

The tear usually heals in about 10 days without special treatment. Surgery is rarely required. Prescription antacids (proton pump inhibitors or H2 blockers) may be given.

If blood loss has been great, blood transfusions may be necessary. Excessive bleeding may need to be treated by using an endoscope (see EGD). In most cases, bleeding stops without specific treatment within a few hours.

Outlook (Prognosis)

Repeated bleeding is uncommon, and the outcome is expected to be good.

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.