[A rare complication of ERCP: Mallory-Weiss syndrome].

Sciumè Carmelo, Geraci Girolamo, Pisello Franco, Li Volsi Francesco, Facella Tiziana, Frazzetta Michele, Raimondo Dario, Passariello Paolo, Modica Giuseppe

Università degli Studi di Palermo, Dipartimento di Chirurgia Generale, d'Urgenza e dei Trapianti d'Organo, Sezione di Chirurgia Generale ad Indirizzo Toracico.

Ann Ital Chir. 2005 Mar-Apr;76(2):199-202.

OBJECTIVE

To describe the management and outcome after endoscopic treatment of hematemesis by Mallory-Weiss Syndrome (MWS) occurred after CPRE (suspected choledocolithiasis).

BACKGROUND DATA

Although cough and retching is common during EGD or CPRE, MWS resulting from endoscopy seems to be uncommon (0.0001-0.04%) and always self-limiting.

CASE REPORT

The patient was submitted to CPRE with the suspicion of choledocholithiasis. Eight hours after CPRE the patient presented with hematemesis and hypotension. With emergency EGD, the AA identified a small bleeding mucosal tear (visible vessel with spurting) just proximal to the esophagogastric junction. The patient was safely treated with endoscopic hemoclipping after the failure of sclerotherapy.

CONCLUSIONS

The usefulness of hemoclipping in MWS is emphasized: although always self-limiting, endoscopic hemostasis is mandatory in high risk patients. The hemoclips are effective and safe in hemostasis in the case of bleeding visible vessel (spurting or oozing), even with or after sclerotherapy. The hemoclips not obstacles the healing.