Which of the following is TRUE about Mallory - Weiss syndrome?
Mallory - Weiss syndrome is characterized by a mucosal tear at the gastroesophageal junction following a bout of forceful retching (or vomiting, coughing, or straining). The tear is paial thickness, extends through the mucosa and submucosa, but not through the muscular layer. The clinical picture consists of acute upper gastrointestinal bleeding following bout of retching. The mean age of the patient is 60 years and 80% of them are males. Majority of patients are alcoholics. Other frequent associations with mallory weiss tear are hiatal hernia, NSAIDS abuse and disease related bleeding diathesis. Management: In majority of patients (90%) bleeding stops spontaneously and only suppoive therapy is required. Persistent bleeding is managed by endoscopic electrocoagulation if it fails angiographic techniques are used and if it fails surgery (laparotomy with high gastrotomy with oversewing of the linear tear) is done. Also know: Boerhaave's syndrome: In this syndrome tear is full thickness penetrating completely through all the layers of esophageal wall with spillage of contents into the mediastinum. Sengstaken - blakemore tube will not be able to stop bleeding from mallory weiss as the bleeding is aerial and the pressure in the balloon is not sufficient to overcome the aerial pressure. Ref: Sabiston 18/e, Page 1207 ; CSDT 13/e, Page 496 ; Maingot's 10/e, Page 298
Gastrointestinal reflux
Obesity
Tumor at gastroesophageal junction
Seen in alcoholics