Mucosal lacerations - gastroesophageal junction

Alternative names
Mallory-Weiss tear

Definition
A Mallory-Weiss tear occurs in the mucous membrane at the junction of the esophagus and the stomach, causing bleeding.

Causes, incidence, and risk factors

Mallory-Weiss tears are usually caused by forceful or prolonged 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

Signs and tests

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).

Expectations (prognosis)
Recurrent bleeding is uncommon, and the outcome is expected to be good.

Complications

Hemorrhage (loss of blood)

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

Prevention
Measures to relieve Vomiting and coughing may reduce risk. Avoid excessive alcohol use.

Johns Hopkins patient information

Last revised: December 8, 2012
by Brenda A. Kuper, M.D.

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