Gastroenterology · USMLE Step 1 and Step 2

Mallory-Weiss Syndrome song

Mallory-Weiss Syndrome - Diagnosis & Management, as a song. Hear the short teaser here. The full song is on YouTube and Spotify.

Mallory-Weiss Syndrome

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Key points in this song10

Mallory-Weiss syndrome is caused by longitudinal mucosal lacerations at the gastroesophageal junction, classically following forceful or repeated vomiting.
The most common clinical presentation is painless upper GI bleeding (hematemesis) following an episode of retching or vomiting, often in the setting of alcohol use.
Unlike Boerhaave syndrome, Mallory-Weiss tears involve only the mucosa and submucosa, not full-thickness esophageal rupture.
Esophagogastroduodenoscopy (EGD) is both the diagnostic and therapeutic modality of choice, allowing direct visualization and endoscopic hemostasis.
The majority of Mallory-Weiss tears (approximately 90%) stop bleeding spontaneously and resolve with supportive care.
Risk factors include alcoholism, hiatal hernia, bulimia nervosa, and any condition causing increased intra-abdominal pressure such as severe coughing or seizures.
Portal hypertension increases the risk of significant hemorrhage in Mallory-Weiss syndrome because of associated coagulopathy and varices.
The tear is most commonly located on the gastric side of the gastroesophageal junction, not the esophageal side.
Endoscopic therapies used for persistent bleeding include epinephrine injection, thermal coagulation, and hemostatic clip placement.
Arterial embolization or surgical oversewing of the bleeding vessel is reserved for refractory cases that fail endoscopic management.