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Mallory–Weiss syndrome
Published in Mohammad Ibrarullah, Atlas of Diagnostic Endoscopy, 2019
Mallory–Weiss syndrome accounts for 5%–10% of all cases of upper gastrointestinal bleeding. The typical presentation is frank hematemesis or blood streaking of vomitus that follows normal bouts of vomiting occurring in the setting of alcoholism, food poisoning or hyperemesis gravidarum. On endoscopy, it is characterized by one or more linear mucosal tear involving the GE junction. The tear may extend for variable distance onto the GE junction. Bleeding from such a lesion is usually mild and self-limiting and responds to conservative management. Endoscopic intervention, in the form of local adrenaline saline injection, thermal coagulation, hemoclip application or banding may be required in the rare event of continued bleeding.
The digestive system
Published in Laurie K. McCorry, Martin M. Zdanowicz, Cynthia Y. Gonnella, Essentials of Human Physiology and Pathophysiology for Pharmacy and Allied Health, 2019
Laurie K. McCorry, Martin M. Zdanowicz, Cynthia Y. Gonnella
Mallory-Weiss SyndromeA condition in which longitudinal tears occur in the walls of the lower esophagus.Most commonly occurs after an episode of severe vomiting (i.e., alcoholism, acute illness).May be associated with acute bleeding and esophageal injury
Classes of Compounds with GI Tract Toxicity
Published in Shayne C. Gad, Toxicology of the Gastrointestinal Tract, 2018
Amy L. Mihalchik, Erica N. Rogers
Tissues of the upper GI tract are exposed to nearly undiluted alcohol prior to reaching the stomach, and at increased acute risk of mucosal damage at doses exceeding two ounces (roughly equivalent to four standard alcoholic beverages in one sitting, typically defined as “heavy” drinking). Chronic alcohol abuse may result in hypertrophy of the parotid glands (primary salivary glands), dental problems, glossitis (tongue inflammation), stomatitis (mouth inflammation), abnormal esophageal motility, and esophagitis, which may present with or without concurrent erosions. Furthermore, chronic alcoholics may develop Barrett’s esophagus, a disorder characterized by epithelial dysfunction and abnormal acid secretion used as an indicator for increased risk of developing esophageal cancer. Alcoholics may also develop Mallory-Weiss syndrome, identified by excessive bleeding resulting from mucosal tears at the gastroesophageal junction related to repetitive vomiting (Bode & Bode, 1997).
Factors for unsuccessful endoscopic hemostasis in patients with severe peptic ulcer bleeding
Published in Scandinavian Journal of Gastroenterology, 2021
Yo Kubota, Hiroshi Yamauchi, Kento Nakatani, Tomohisa Iwai, Kenji Ishido, Tomonari Masuda, Takaaki Maruhashi, Satoshi Tanabe
Between 1 April 2007 and 31 March 2021, 512 patients underwent endoscopic hemostasis for shock-presenting upper gastrointestinal bleeding at the Critical Care Center of Kitasato University Hospital. Shock was defined as a condition with symptoms including either a heart rate of >100 beats/min, respiratory rate of >20 breaths/min, or systolic blood pressure of < 90 mmHg, and as a condition with clinical symptoms of either disturbed consciousness, perspiration, or peripheral cyanosis. Among the 366 cases of severe peptic ulcer bleeding, variceal upper gastrointestinal bleeding (esophageal varices rupture, 76 cases; gastric varices rupture, 12 cases), esophageal bleeding (Mallory–Weiss syndrome, 24 cases; esophageal ulcer, 24 cases; and corrosive esophagitis, 4 cases), and aorto-gastrointestinal perforation (6 cases) were excluded, and 150 cases that met the eligibility criteria were included in the analysis (Figure 1).
An overview of the clinical management of cyclic vomiting syndrome in childhood
Published in Current Medical Research and Opinion, 2018
Claudio Romano, Valeria Dipasquale, Anna Rybak, Donatella Comito, Osvaldo Borrelli
As stated by the NASPGHAN consensus report, the diagnosis of CVS is based upon the fulfillment of the diagnostic criteria in the absence of another explanation of the symptoms6. Up to now, no diagnostic biomarkers in CVS have been identified, and diagnosis still remains largely one of exclusion. The presence of symptoms and signs suggestive of underlying organic conditions (Table 3) allows clinicians to proceed to other investigations, mainly represented by laboratory investigations, including metabolic tests, and imaging modalities, such as intestinal magnetic resonance, abdomen and pelvis ultrasound, and brain imaging6. The British Inherited Metabolic Disease Group (BIMDG) investigation list for CVS may offer a valid baseline to work on (http://www.bimdg.org.uk/store/guidelines/Cyclical_vomiting_2016_393331_09092016.pdf). An esophagogastroduodenoscopy may be required, since hematemesis may occur after repeated vomiting episodes (Mallory–Weiss Syndrome)24. Olson and Li performed a cost-effectiveness evaluation comparing extensive diagnostic evaluation, empiric treatment alone and upper gastrointestinal radiology with small-bowel follow-through plus empiric treatment (for 2 months). The last strategy was proven to be the most cost-effective24.
High-Altitude-Induced alterations in Gut-Immune Axis: A review
Published in International Reviews of Immunology, 2018
Kunjan Khanna, K P Mishra, Lilly Ganju, Bhuvnesh Kumar, Shashi Bala Singh
High Altitude exposure can cause a risk of upper GI tract bleeding when exposed to 5000 m and especially risk increases when aspirin, dexamethasone or alcohol is consumed.14,24 In a study of Upper Gastro-Intestinal Bleeding (UGIB) at moderate altitude, it was found that there was high incidence of peptic and duodenal ulcers, haemodynamic instability and its occurrence was more in male patients. These symptoms were similar to UGIB at high altitude, whereas symptoms like Mallory-Weiss syndrome, need for surgery, mortality and incidence of oesophageal varices were similar to UGIB at low altitude.12