Abstract
Ninety cases of Mallory-Weiss syndrome (M-W syndrome) were analyzed on their clinical features. As the inducing factors of M-W syndrome, alcohol intake was 40.0% and endoscopy was 13.3%. The tears were almost located in the cardia, in which about a half of the tears were found on the lesser curvature. The number of the tears ranged from one to four and 71.2% had a single tear. Accompanied lesions of the upper gastrointestinal tract, such as erosive gastritis or gastric ulcer were recognized in over a half of the cases. Most of the tears healed within 3 weeks. The average period of healing was 9.1 days in the linear tears and 18.7 days in the spindle-shaped tears. Six cases required blood transfusion and/or endoscopic hemostatic procedures. Five of them occured after alcohol intake and one during endoscopic examination. Several spindle-shaped tears were mainly observed near the lesser curvature of esophago-cardiac junction or cardia in most of these cases. Endoscopic hemostatic procedure was performed to 4 cases in which vessels with massive bleeding were exposed. Among them, local injection of Aethoxysklerol® was done in 3 cases, and it was very successful. Only one case was operated (1.1%). In this case, the first endoscopic examination revealed some linear tears without bleeding, but massive re-bleeding occured and local injection of absolute ethanol was not effective. Most cases of M-W syndrome improved rapidly, but some cases in which massive bleeding could not be controlled, especially in patients with liver cirrhosis. So it is considered that early diagnosis and endoscopic hemostatic procedures are very important.
