MALLORY-WEISS SYNDROME

A total of 121 cases of Mallory-Weiss syndrome have been reported in the English literature up to 1965. Since 1965 a retrospective study and review of the recent English world medical literature provided 108 new cases of the Mallory-Weiss syndrome and disclosed several new predisposing causes of this syndrome. Only 90.7 per cent of cases resulted from violent retching or vomiting whereas 9.2 per cent resulted from other events such as closed chest cardiac massage, severe coughing, straining at stool, heavy lifting, and in hiccuping under anesthesia. An increased number of postemetic lacerations were reported due to diverse precipitating causes other than an alcoholic debauch. In our report only 60 per cent of postemetic tears resulted from an alcoholic episode. The tears are usually single but in 27 per cent of cases two or more tears were present and had to be vigorously sought, recognized, and plicated at surgery. Seventy-six per cent of the lesions were located entirely within gastric mucosa, whereas 5 per cent were confined to the esophageal mucosa alone. The tears confined to the esophagus may be recognized only if the esophagus is examined by either antegrade or retrograde endoscopy or by opening the esophagus. The mortality is steadily decreasing, primarily due to increasing awareness and recognition of this lesion plus improved supportive management of patients with hemorrhage. © 1969.