• Clinical science

Mallory-Weiss syndrome


Mallory-Weiss syndrome refers to acute upper gastrointestinal bleeding caused by mucous membrane lacerations at the gastroesophageal junction, although it may extend above or below. Forceful vomiting in the presence of a damaged gastric mucous membrane, often related to alcoholism, is a common cause of Mallory-Weiss syndrome. Patients typically present with a history of epigastric pain and hematemesis. Esophagogastroduodenoscopy is important in both the diagnosis of the condition and its treatment, which involves simultaneous hemostasis.


  • Longitudinal mucous membrane tears (limited to the mucosa and submucosa) at the gastroesophageal junction



Epidemiological data refers to the US, unless otherwise specified.


References: [2]

Clinical features

  • May be asymptomatic
  • Epigastric or back pain
  • Hematemesis
  • Possible shock with massive hemorrhage



  • Esophagogastroduodenoscopy
    • Often a single longitudinal tear (multiple tears are possible) in the mucosa at the esophagogastric junction
    • A clot or active bleeding may be evident


Differential diagnoses

The differential diagnoses listed here are not exhaustive.


General measures

  • If bleedings stops spontaneously conservative treatment is usually sufficient
  • Control of precipitating factors (e.g., omeprazole for GERD)
  • Inpatient monitoring
  • Treat hemodynamic instability if present

Surgical treatment

  • Indication: actively bleeding lesion
  • Gold standard: esophagogastroduodenoscopy
  • Second-line treatment : angiography (embolization, vasopressin infusion)


last updated 12/06/2019
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