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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Since the original report by Mallory and Weiss of tears in the lower esophagus or cardia of the stomach following alcoholic debauch, there have been many other cases, associated with sundry other causes, described in the literature. Recently, a Mallory-Weiss tear was reported in a patient as a complication of cancer chemotherapy. This article describes two similar cases and suggests that the Mallory-Weiss syndrome should be included in the differential diagnosis of any patient with epigastric pain, hematemesis, or melena after chemotherapy-induced retching or vomiting.
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PMID:Mallory-Weiss tear. A complication of cancer chemotherapy. 668 87

Belching and severe vomiting may lead in association with gastro-oesophageal prolapse to a variety of lesions within the gastro-oesophageal junction. Incarceration of the prolapse, diffuse hemorrhage from the prolapsed mucosa, longitudinal lacerations (Mallory-Weiss syndrome), intramural hematoma and spontaneous rupture (Boerhaave syndrome) are the most common complications. Based on 4 cases of incomplete rupture of the oesophagus we would like to draw attention to a disorder with mediastinal emphysema or pneumopericardium following severe vomiting. It is postulated that air escapes from a mucosal tear in the terminal oesophagus into the mediastinum. Conservative treatment seems justified.
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PMID:[Incomplete spontaneous esophageal rupture - a variant of the Mallory-Weiss and Boerhaave syndrome?]. 688 Mar 17

Twenty seven patients, inspected by endoscope, and diagnosed as having the Mallory-Weiss syndrome, have been studied taking into account their age, sex, background, clinic presentation, manifestations, number of lacerations, associated lesions and evolution. Twenty three of them were males and 4 females. The age average was 46.7 years. Only 8 patients had intra-abdominal increased pressure, suffering retching and vomiting 7 of them, while one had a cough access. Out of the 21 patients that we controlled, 9 were chronic alcoholism while 3 had ethanol intoxication previously. Immediate prior ingestion of salicylates had taken place in 6 patients. The clinical presentation of 22 of them was gastrointestinal bleeding, that is, 4.9% of all the upper endoscopies carried out within the bleeding patients. Single laceration was present in 22 cases, double one in 4, and triple in 1. We have frequently found endoscopy lesions associated, the most common one (37%), was hiatal hernia. They all were medically treated except one, who was operated because of gastric perforation was associated. Just one of the Mallory-Weiss syndrome patient died, due to an associated diffused bleeding gastritis.
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PMID:[Mallory-Weiss syndrome. Considerations on 27 cases]. 697 2

We report four cases of esophageal hematoma and emphasize that endoscopically and radiographically it may simulate a neoplasm. After a review of 26 cases, we found that patients with normal hemostasis often had esophageal hematoma occur distally after vomiting. Most of these hematomas probably originated from a Mallory-Weiss laceration. In contrast, patients with impaired hemostasis had esophageal hematoma occur proximally or at multiple sites. Many of these hematomas occurred spontaneously, without a history of vomiting, and probably resulted from impaired coagulation. Regardless of etiology most esophageal hematomas were associated with a benign course.
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PMID:Esophageal hematoma. Four new cases, a review, and proposed etiology. 702 29

Current methods to evaluate patients with esophageal disease include barium swallow with fluoroscopy, which is useful in demonstrating structural defects. Disordered motility is better evaluated with a cine-esophagram. Recent application of radioisotopes has been useful in evaluation of esophageal reflux and the post-treatment of achalasia. Esophageal motility studies may evaluate lower esophageal sphincter and upper esophageal sphincter pressures and the response of the body of the esophagus to series of swallows. Since there is no "gold standard" for the evaluation of reflux esophagitis, some of the tests designed to evaluate reflux and the patient's reaction to acid in the esophagus include the acid infusion test, the standard acid reflux test, the acid clearance test, and 24-hour pH monitoring. Endoscopy with either the flexible or the rigid instrument is important for the diagnosis of obstruction or esophagitis and allows direct visualization of the esophagus. The treatment of reflux esophagitis is discussed. The differential diagnosis of dysphagia may include achalasia, diffuse esophageal spasm, and mechanical obstruction of the esophagus due to rings, webs, strictures, and benign or malignant tumors. The evaluation of dysphagia should include radiologic as well as endoscopic evaluation. Treatment of obstruction varies according to the nature of the lesion. The Mallory-Weiss syndrome or bleeding from the mucosal tears of the gastroesophageal junction and Boerhaave's syndrome, spontaneous esophageal perforation, are two disorders associated with vomiting. The Mallory-Weiss syndrome usually resolves without specific therapy, but a high index of suspicion is required for patients with chest pain after vomiting, as spontaneous perforation necessitates immediate surgery. Most diverticula need no treatment, but the Zenker diverticulum, if symptomatic, should probably be surgically repaired.
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PMID:Evaluation and management of diseases of the esophagus. 703 70

The Mallory-Weiss syndrome is a relatively infrequent cause of digestive tract bleeding and most cases have been described in alcoholics. Nonoperative management is frequently successful. We present here a case of sudden onset of wretching and vomiting after IV infusion of cis-platinum for recurrent carcinoma of the uterine cervix in which the patient had profuse hematemesis secondary to three posterior gastroesophageal tears requiring operative intervention after failure of nonsurgical management. This is an unusual complication of antineoplastic chemotherapy and its prevention is emphasize in this paper.
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PMID:Mallory-Weiss syndrome secondary to cis-platinum chemotherapy: an unusual complication. 720 84

This paper presents an unusual case of gastrointestinal (GI) bleeding which followed a period of nausea and vomiting in a quadriplegic patient in whom endoscopy revealed a tear in the distal esophagus. Similar lesions have been described as the Mallory-Weiss syndrome. The physiology of vomiting is presented, wherein abdominal muscle contraction plays a partial role. The pathophysiology in the patient who lacks functional abdominal muscles is considered in relation to etiology. It is suggested that mucosal tears similar to those associated with a Mallory-Weiss syndrome be added to the differential diagnosis of upper GI bleeding in quadriplegic patients.
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PMID:Upper gastrointestinal bleeding in a quadriplegic patient. 724 62

During a 19-year period ending December 1978, we treated 40 patients with upper gastrointestinal bleeding secondary to the Mallory-Weiss syndrome. Thirty patients had the triad of vomiting, hematemesis and alcoholism. The presence of lacerations within the gastric cardia was associated with the presence of hiatal hernia (p = 0.03). Endoscopic examinations demonstrated 32 of 38 additional upper gastrointestinal lesions associated with the syndrome that could have been mistaken as the actual source of hemorrhage. During the second decade, as compared with the first decade, widespread use of fiberoptic esophagogastroscopy led to the identification of the bleeding lacerations in 71% of the patients (versus 47% in the first decade) and in 80% (versus 0% in the first decade) of the patients who required an operation to control the bleeding. Although there was a 7.5% mortality rate in the two decades, the incidence of operative treatment tended to decrease (42-24%; p = 0.13). More impressive were the decreases in transfusions (14 units to 5 units per patient) and in delays before surgery (38 hours to 17 hours) (p equal to 0.05). Improved endoscopic diagnosis facilitates prompt and economic treatment.
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PMID:Mallory-Weiss syndrome. Evolution of diagnostic and therapeutic patterns over two decades. 744 23

Mallory-Weiss tears are a common cause of upper gastrointestinal bleeding and are often associated with vomiting from heavy alcohol ingestion. Other causes of severe emesis can induce a Mallory-Weiss tear, and it may be important to diagnose these conditions so that appropriate therapy can be instituted. We report an unusual condition presenting with a Mallory-Weiss tear, a small bowel obstruction resulting from an occult Richter's hernia, which was not suspected or diagnosed at initial presentation.
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PMID:Upper gastrointestinal hemorrhage from a Mallory-Weiss tear associated with an occult Richter's hernia and small bowel obstruction: to see the forest as well as the trees in the emergency department. 796 90

Cases of Mallory-Weiss syndrome aged over 75 year were analyzed with regard to their clinical features. In a 5-year period, there were 9 such cases, representing 19% of the total number of Mallory-Weiss syndrome cases. Four patients had a history of retching or vomiting, but in the other 5 patients, Mallory-Weiss tears occurred during endoscopic examination with slight vomiting reflex or even almost vomiting reflex. The latter cases had a spindle-shaped tear which was located on the lesser curvature at the cardia of the stomach. All patients were managed conservatively by observation without endoscopic hemostatic procedure, because the amount of bleeding was small. The 5 patients were thin and three of them had chronic atrophic gastritis. Mucosal weakness is an important etiologic factor in aged patients who develop Mallory-Weiss syndrome.
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PMID:[Clinical study of Mallory-Weiss syndrome in the aged patients over 75 year--mainly five cases induced by the endoscopic examination]. 807 8


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