Mallory-Weiss Syndrome Follow-up

Updated: Jun 27, 2016
  • Author: Carmen Cuffari, MD; Chief Editor: Carmen Cuffari, MD  more...
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Follow-up

Further Outpatient Care

Mallory-Weiss tears almost never rebleed; thus, follow-up is not usually indicated.

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Further Inpatient Care

Two types of endoscopic therapy can be used to control severe bleeding in patients who are hemodynamically unstable because of bleeding from a Mallory-Weiss tear.

  • Injection therapy is favored as the first-line therapy by most endoscopists for control of bleeding esophageal lesions because of its ease of use, safety, and cost. Typically, the injections are made 3-5 mm apart circumferentially around the site of bleeding in 4 areas. The chemical agents used for injection therapy include dilute epinephrine, sodium morrhuate, ethyl alcohol, or sodium tetradecyl sulfate.
  • Heater probe or bipolar coagulation therapies use electrical current supplied by catheters that can be inserted into an endoscope to control bleeding. Approximately 20 joules (10-15 Watts) of current are used per individual pulse, and treatment is complete when the bleeding has ceased. The current is usually delivered in repeated time-limited pulses.

Evaluate the underlying cause of vomiting.

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Transfer

Transfer children with severe uncontrolled bleeding to a tertiary care hospital with an in-house pediatric gastroenterologist.

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Deterrence/Prevention

Avoid and treat causes of underlying vomiting and retching.

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Complications

Complications include the following:

  • Anemia

  • Dehydration

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Prognosis

Prognosis is extremely good in children, with a less than 0.01% mortality rate. These tears almost always respond to conservative therapy and supportive care. [16]

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