Ver el código de «Mallory-Weiss tear»

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==Background==

[[File:Gray1032.png|thumb|Posterior view of the position and relation of the esophagus in the cervical region and in the posterior mediastinum.]]
[[File:Layers of the GI Tract english.svg|thumb|Layers of the GI track: the mucosa, submucosa, muscularis, and serosa.]]
[[File:Illu esophagus.jpg|thumb|Esophagus anatomy and nomenclature based on two systems.]]
*Longitudinal lacerations through mucosa and submucosa
*75% in proximal stomach, rest in distal esophagus 
*Due to sudden increase in intrabdominal pressure 
**Typically in the setting of forceful vomiting or retching


==Clinical Features==


===Risk Factors===

*Hiatal hernia
*[[Special:MyLanguage/Alcoholism|Alcoholism]]
*Anything that increases intrabdominal pressure: blunt [[Special:MyLanguage/abdominal trauma|abdominal trauma]], CPR, etc.


===History===

*Classic presentation: [[Special:MyLanguage/Hematemesis|Hematemesis]] following vomiting or retching
**As few as 30% of patients present this way
*Coffee ground emesis
*[[Special:MyLanguage/Melena|Melena]]
*Hematochezia


==Differential Diagnosis==

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==Evaluation==

[[File:Mallory Weiss Tear.png|thumb|Mallory–Weiss tear affecting the esophageal side of the gastroesophageal junction.]]
*Approach as any GI bleed
**CBC
**BMP
**Type and screen
**Guiac
**[[Special:MyLanguage/CXR|CXR]]
*Definitive diagnosis by endoscopy


==Management==

*Most Mallory-Weiss tears are minor and resolve on their own, but up to 3% of upper gastrointestinal bleeding deaths are a result of Mallory-Weiss tears
*Endoscopy only for active and on-going bleeding<ref>Gyawali CP. The Washington Manual Gastroenterology Subspecialty Consult 2ed. 2008. Washington University School of Medicine.</ref>
*Treat as [[Special:MyLanguage/undifferentiated upper GI bleed|undifferentiated upper GI bleed]]
**Many of these patients are alcoholics and have cirrhosis; consider esophageal varices
**History of vomiting/retching; consider [[Special:MyLanguage/boerhaave|boerhaave]]  


===Treatments Not Supported by the Literature===

*No evidence to support octreotide use


==Disposition==

*Anticipate admission


==See Also==

*[[Special:MyLanguage/Gastrointestinal bleeding|Gastrointestinal bleeding]]
*[[Special:MyLanguage/Upper gastrointestinal bleeding|Upper gastrointestinal bleeding]]


==External Links==


==References==

<references/>

[[Category:GI]]
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