Mallory-Weiss Syndrome

Mallory-Weiss syndrome (MWS) is recognized as one of the causes of nonvariceal upper gastrointestinal haemorrhage, accounting for 3% to 10% of cases. First described in 1929 by Kenneth Mallory and Soma Weiss, MWS is defined by superficial, longitudinal mucosal lacerations at the esophagogastric junction. These tears result from a sudden increase in intra-abdominal pressure, typically induced by recurrent vomiting, forceful retching, or severe coughing. Although traditionally associated with alcohol use, MWS may also occur in the setting of pregnancy, eating disorders, or endoscopic procedures. The diagnosis of MWS should be considered in patients with upper gastrointestinal bleeding preceded by vomiting of clear fluid or bile, followed by hematemesis. Confirmation is achieved by esophagogastroduodenoscopy (EGD), which enables direct visualization of the mucosal tear and therapeutic hemostasis when indicated. Most Mallory-Weiss tears, reported in up to 90% of cases, resolve spontaneously without endoscopic or other intervention. The rebleeding rate after successful hemostasis is approximately 7%, typically occurring within 24 hours of the initial procedure. Optimal care requires an interprofessional approach, with timely recognition of risk factors and coordinated management essential for reducing recurrence and preventing complications.