Mallory-Weiss Syndrome
- Longitudinal tears in the oesophagus at the oesophagogastric junction or gastric cardia
- Believed to be due to severe vomiting or retching with failure of LOS relaxation
- Most commonly seen in alcoholics
- It may lead to massive haematemasis, inflammation, ulceration, mediatinitis or peritonitis
Morphology
- Lacerations are longitudinal are may be several mm to several cm in length
- The tears may involve only the mucosa or may penetrate deeply enough to perforate the wall
- The histology is not distinctive and reflects trauma accompanied by fresh haemorrhage and non-specific inflammation
- Infection of the mucosal defect may lead to an inflammatory ulcer or to mediastinitis
Clinical features
- Oesophageal lacerations account for 5-10% of upper GI bleeds
- Lacerations are not generally fatal and bleeding tends to be prompt
- Rarely there may be oesophageal rupture called Boerhaave syndrome