MALLORY-WEISS SYNDROME: REVIEW OF A THIRTEEN-YEAR PERIOD

Background Acute upper gastrointestinal hemorrhage is a frequent problem of emergency medicine. Mallory-Weiss syndrome, a laceration at the esophagogastric junction, is an uncommon source of acute upper gastrointestinal hemorrhage. The purpose of the study was to evaluate the incidence of Mallory-Weiss tear and to assess the efficiency of endoscopic and supportive treatment in a prospective, cohort study. Patients and methods The study includes patients with emergency endoscopy due to acute upper gastrointestinal hemorrhage between January 1, 1994 and December 31, 2006. Results 7921 patients were investigated: 3010 female (38 %) and 4911 male (62 %), their average age was 59.5 years, SD +/- 17.3, with a 1-106 year span. In 228 patients (2.9 %, 165 male, av. age 52 years, SD +/- 17.1, range 7-90 years and 63 female, av. age 58.8 years, SD +/- 19.2 years, range 20-94 years) a Mallory-Weiss tear was found. In 136 patients (59.5 %) emergency endoscopy revealed signs of acute or traces of previous hemorrhage. Different methods of endoscopic hemostasis were carried out in 105 cases (46 %), hemostasis was successful in 102 patients (97 %). The total mortality of our patients was 7.8 % (18/228 patients), the majority of them died due to concommitant diseases and complications during treatment. Conclusions Urgent endoscopy with different hemostatic procedures and modern supportive treatment have significantly improved the outcome of patients with these source of upper gastrointestinal hemorrhage.