The Mallory-Weiss Syndrome
The Mallory-Weiss syndrome is a longitudinal fissure of the gastric mucosa, which serves as a source of gastrointestinal bleeding. In most cases, this syndrome is manifested after consuming large doses of alcohol or taking large amounts of food.
According to statistical data, Mallory-Weiss syndrome is responsible for about 10% of all gastrointestinal bleeding. Most often this syndrome occurs in males aged 45 to 65 who are prone to alcohol abuse
The Mallory-Weiss Syndrome
In most cases, this syndrome occurs due to increased pressure in the upper gastrointestinal tract (gastrointestinal tract), which leads to rupture of the mucous membrane of the gastrointestinal junction. The reasons for the increase in pressure include: hiccough, cough, vomiting (due to overeating, drinking excessive amounts of alcohol, cholecystitis, pancreatitis, pregnancy, etc.), cardiopulmonary resuscitation, diaphragmatic hernia, damage to the esophagus during fibroesophagogastroduodenoscopy, blunt abdominal trauma Accident, falling from a height, blow to the abdomen)
The Mallory-Weiss Syndrome Symptoms
Clinically, this syndrome manifests itself in the presence of vomit masses of blood fragments (often with clots). In this case, blood during the observed first attacks of vomiting can be completely absent, since it manifests only after rupture of the mucosa. In patients besides vomiting with an admixture of blood, there may be pain in the abdominal area and a black chair.
The diagnosis is established based on the results obtained during the endoscopic examination. Also, when carrying out endoscopy, measures are simultaneously taken to localize and stop bleeding
The Mallory-Weiss syndrome treatment
At the time of fibroesophagogastroduodenoscopy, if there is a bleeding rupture of the esophageal mucosa, first of all, attempts are made to stop this bleeding endoscopically, using: argon-plasma coagulation, adrenaline clotting, electrocoagulation, vascular clipping, vascular ligation, introduction of sclerosants.
In Mallory-Weiss syndrome, conservative therapy is also used, which is aimed at restoring the volume of circulating blood. For these purposes, various colloidal (aminoplasmal, albumin, etc.) and crystalloid (5% glucose, Ringer's solution, etc.) solutions are used. In case of sufficiently severe hemorrhage, blood transfusion is used (fresh frozen plasma, erythrocyte mass). When urge to vomit (when vomiting) apply cerukal (metoclopramide). To stop bleeding, a Blackmore probe is used. To stop bleeding, calcium chloride, octreatine, aminocaproic acid, sodium ethamidate are used.
Surgical treatment of Mallory-Weiss syndrome is only used if the desired results were not achieved with endoscopic treatment and conservative therapy. This method of treatment consists in carrying out gastrotomy and flushing of bleeding vessels.
The prognosis of further life in the Mallory-Weiss syndrome is quite favorable. In the vast majority of cases, bleeding can be stopped.