Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:3.4.21.5 (thrombin)
 33,306 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Once considered rare, Mallory-Weiss syndrome is today more frequently reported due to the introduction of endoscopy which reveals this syndrome in up to 15% of hemorrhages of the upper digestive tract. The etiopathogenesis is not limited to the three factors reported by Mallory and Weiss in 1929: vomit, alcohol and hematemesis. An important role is also played by ASA and the like. This syndrome is also frequently associated with hiatus hernia in which it appears to be a complication since the lesion seems to be caused by the difference between intragastric (above all in the pocket of the hiatus hernia) and intrathoracic transmural pressure. Every increase in the pressure gradient at this level appears to cause fissuration at the cardioesophageal junction. Even endoscopy using rigid instruments and unsufflation may provoke the onset. Anamnesis and an objective examination, common to other pathologies, are not of great value to diagnosis. Radiology also contributes little, unless an arteriography is performed within the context of a highly selective angiography. Endoscopy is the prime method of diagnosis and, in addition to revealing the site and extent of hemorrhage, may be used to achieve hemostasis. Preendoscopic hemostasis currently uses a wide range of methods ranging from sclerotherapy to the injection of drugs or chemical substances, such as ethanol, adrenalin and thrombin; monopolar and bipolar electrocoagulation, thermal probe, hemoclips and Nd:YAG laser are also used. According to the majority of authors, the course of the syndrome is benign unless there are complications such as mediastinitis, pneumonia ab ingestis or hepatic insufficiency. The degree of bleeding is also decisive and the number of blood units transfused is of particular importance in determining the prognosis. The authors report a 10-year survival rate of approximately 70%.
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PMID:[Mallory-Weiss syndrome. Clinical cases and review of the literature]. 767 85

A 62-year-old man with a chief complaint of coughing up blood was revealed to have Mallory-Weiss syndrome with arterial bleeding by gastrointestinal endoscopy at the esophagogastric junction, and two teardrop-shaped fissures were found longitudinally extending into the muscle layer. Endoscopic treatment with ethanol injection and the administration of a thrombin solution spray failed to control the arterial bleeding. Hemostasis was finally archived by suturing the fissures under an open laparotomy. A postoperative barium esophagogram showed multiple flask-shaped outpouchings in the thoracic esophagus, and a diagnosis of esophageal intramural pseudodiverticulosis (EIPD) was thus made. EIPD is usually accompained with esophageal strictures but esophageal bleeding is rare.
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PMID:Esophageal intramural pseudodiverticulosis with Mallory-Weiss syndrome: report of a case. 1210 78