Sudden hematemesis in a patient on Alcohol with mucosal tear is:
High-Yield Explanation
Ans. a. Mallory-weiss syndromeMALLORY-WEISS SYNDROMEPathogenesisMallory-weiss syndrome is a non-transmural tear of the lower esophagus that is related to repeated episodes of retching and vomiting after heavy drinking.Clinical PresentationAlthough Mallory-Weiss syndrome is an esophageal disorder, the presentation is markedly different from the others.Most common age group 60 years, 80% are men; alcoholic.Mallory-Weiss does not present with dysphagia or odynophagia.It presents with painless upper GI bleeding.Patients develop black stool from melena if the volume of bleeding is >100 mL or with hematemesis if there is continued vomiting.DiagnosisThese patients are diagnosed by direct visualization on upper endoscopy.TreatmentMost of the time, Mallory-Weiss tears require no direct therapy and will resolve spontaneously.Initial treatment is conservative.Sometimes, injection of the tear with epinephrine or performing cauterization is necessary.