Tuesday, December 14, 2010

Mallory-Weiss Syndrome.


Longitudinal tears in the esophagus at the esophagogastric junction
chronic alcoholics after a bout of severe retching or vomiting, but they may also occur during acute illnesses with severe vomiting
a hiatal hernia is found in more than 75% of patients with Mallory-Weiss tears.
Many pts with Mallory-Weiss tear have no antecedent history of nausea, retching, abdominal pain, or vomiting
Infection of the defect may lead to an inflammatory ulcer or to mediastinitis.
Even with severe blood loss, supportive therapy with vasoconstrictive medications, transfusions, and sometimes balloon tamponade, is usually all that is required
Boerhaave syndrome: rupture with pneumomediastinum, subcutaneous emphysema and mediastinitis
Esophageal instrumentation is the most common cause

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