A 38-year old homeless male develops sudden onset hematemesis following a bout of severe vomiting and retching. He had no complaints prior to the onset of his symptoms. On examination, he is pale and looks anxious. The vital signs are normal. Laboratory investigations show normal liver function tests, a low Hb and high MCV, chest X-ray is normal. The above problem on endoscopy would appear as -
High-Yield Explanation
Potential Mechanisms for Mallory-Weiss Tears A Mallory-Weiss tear likely occurs as a result of a large, rapidly occurring, and transient transmural pressure gradient across the region of the gastroesophageal junction. Acute distention of the nondistensible lower esophagus can also produce a linear tear in this region Ref Davidson 23rd edition pg821