MALLORY – WEISS

TEARS
• A linear laceration at the gastroesophageal junction

• The cylindrical shape of the esophagus and the

stomach allows longitudinal tears to occur more easily
than circumferential tears.

• Occurs either through rapid increase or a significant

change in intragastric pressure and distention.
• Occurs in less than 5% of children who have
predisposing medical conditions such as hypertension,
liver cirrhosis, and severe gastroesopageal reflux.

• Any disorder that initiates vomiting may result in the

development of Mallory-Weiss tears.
Clinical Manifestations
• Children may present with hematemesis, which may
vary from flecks or streaks of blood mixed with gastric
contents
• Mucus to several ounces of bright red bloody emesis
• Melena
• Epigastric pain
• Lightheadedness
• Dizziness
Diagnosis
• Definitive diagnosis is established by upper endoscopy
by identifying active bleeding

• HALLMARK: LINEAR BLEEDING LESION AT THE

ESOPHAGOGASTRIC JUNCTION OR PROXIMAL TO
IT
Treatment

• In most cases Mallory-Weiss tears spontaneously resolve

• In patients with persistent bleeding, esophageal clips may

be applied to the lesion, or band ligation may be
performed

• Fasting may be required in patients who are

hemodynamically unstable
• Unless there is nausea or vomiting patients may
resume to regular intake after an endoscopy

• Diet may start from clear liquid to full liquid diet, and
slowly advancing to diet as tolerated within 48 hours