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Results for “Mallory-Weiss Syndrome”

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At least 19 recordsLinked to original sources
PubMed1978

The Mallory-Weiss syndrome. A review of 23 cases with special reference to coagulation defects.

The Mallory-Weiss syndrome is defined as bleeding from longitudinal tears in the gastro-oesophageal junction. The characteristic history consists of repeated vomiting followed by sudden haematemesis. During the past 4 1/2 years, 23 patients, 17 males and 6 females with the diagnosis of Mallory-Weiss syndrome were treated in our institution. An aetiological factor has been sought for. In a review of the case-records, we discovered that many patients had coagulation defects on admission. This was verified with extended coagulation tests at later follow-up. It is proposed that non-bleeding lacerations in the cardiac orifice in conjunction with vomiting is a common occurence, and that the Mallory-Weiss syndrome may be regarded as a complication occuring predominantly in patients with some coagulation defect.

Adult↗
PubMed1977

Mallory-Weiss syndrome. A changing clinical picture.

A retrospective study of 18 episodes of upper gastrointestinal (UGI) bleeding secondary to Mallory-Weiss syndrome occuring in 16 patients is presented. Reported cases published since 1969 have been summarized and compared with earlier collected series. It is evident that the clinical spectrum, prognosis, and opinion regarding etiology and treatment of the syndrome have changed in the last decade. Increased awareness of gastroesophageal lacerations secondary to emesis as well as other causes of significantly increased intraesophagogastric pressures, and widespread utilization of fiberoptic endoscopy have resulted in identification of Mallory-Weiss syndrome with increasing frequency. Less severe lacerations which are healing with medical therapy are being recognized. It is recommended that endoscopy by performed in all cases of UGI hemorrhage and that patients with Mallory-Weiss syndrome be managed medically unless hemorrhage is massive or persistent since nearly three of four patients can be successfully treated without operation.

Adult↗
PubMed1977

[Major esophageal hemorrhages of unusual origin. A poorly known entity].

Nine cases of severe gastrointestinal haemorrhage as the presentation of oesophageal lesions are reported. Haemorrhages complicating oesophageal varices, carcinoma of the oesophagus and oesophageal surgery were eliminated from the study, as were haemorrhages associated with hiatal hernias or Mallory-Weiss syndrome. Amongst these 9 cases of severe haemorrhage, 5 were due to an ulcer of the oesophagus, 2 to acute oesophagitis, 1 to rupture of the oesophagus and one to a traumatic aneurysm of the aorta rupturing into the oesophagus. The location and cause of bleeding were determined only 3 times before operation and only when a fibroscopic examination had been carried out. At fibroscopy, an irregular lesion responsible for a severe haemorrhage has every chance of being a benign ulcer and not a carcinoma. Treatment directed at the aetiology was carried out in 6 cases and success obtained in 3 patients. The aetiological diagnosis who was not made in 3 patients, who died. The aetiology, diagnosis and therapeutic approach required in such cases of severe haemorrhage of oesophageal origin are considered. In the light of these cases, a possible oesophageal aetiology should be considered as a possible cause of an unexplained severe gastrointestinal haemorrhage. An attempt at proving such a hypothesis by fibroscopy is necessary and, in general, urgent thoracotomy since the bleeding is in most instances of arterial origin.

Adult↗
PubMed1977

The experience of a haematemesis and melaena unit: a review of the first 513 consecutive admissions.

This report is of the results of management in a haematemesis and melaena unit at Prince Henry's Hospital, Melbourne. The unit was established in October, 1972, in response to unpublished data for the decades 1950 to 1959 and 1960 to 1969, which showed a mortality of about 15%. In the 39 months to December, 1975, 513 patients were received into a semi-intensive care setting. The unit staff consisted of a group of four surgeons and four physicians working a weekly roster. Primary care and liaison were the responsibility of the gastroenterology registrar. The basic diagnostic measure taken was the routine early use of fibreoptic duodenoscopy. The unit was set up with an agreed policy of management of the common causes of haematemesis and melaena, and data were prospectively recorded in a form suitable for computer analysis in every case. Of the 513 admissions, 378 were of males and 135 were of females. Forty-five patients died, giving an overall admission mortality of 8-8. There were 143 admissions for bleeding duodenal ulceration, 102 for acute peptic ulceration, 47 for chronic gastriculceration, 43 for oesophageal varices, 33 for Mallory-Weiss syndrome and 45 for less common causes of upper gastrintestinal bleeding. In 100 cases the source of bleeding was not discovered. Of the 143 patients admitted for chronic duodenal ulcer, either patients died, giving a mortality of 5-6%; 72 patients underwent operation, with an operative mortality of 9-7%. Of the 47 admitted with bleeding gastric ulcer, nine died (19-1%), while 26 came to operation; the operative mortality was 26-9%. There were 102 admissions for acute peptic ulceration, with an overall mortality of 11-7% (12 patients); 16 patients came to operation, with an operative mortality of 43-7%. Eleven deaths occurred in the 43 patients admitted for bleeding oesophageal varices (25-6%), with 10 patients coming to operation; the operative mortality was 30-0%. An age of greater than 50 years and shock on admission were the most significant factors for poor prognosis in this group of patients.

Adolescent↗
PubMed1977

[Evaluation of the blood coagulating system in acute gastroduodenal hemorrhages by thromboelastographic data].

Coagulation properties were studied thromboelastographically in 76 patients with acute gastroduodenal hemorrhages due to ulcerous disease of the stomach and duodenum, hemorrhagic gastritis and Mallory-Weiss syndrome. A certain regularity was revealed, i. e. the more profuse the hemorrhage the more frequent hypocoagulation associated with high fibrinolysis rate. With this in view transfusion therapy should be aimed not only at the replacement of circulary blood bolume but also at the suppression of high fibrinolytic activity of blood.

Acute Disease↗
PubMed1977

[New methods of managing massive upper gastrointestinal bleedings (author's transl)].

A four year experience in the management of 585 patients with massive upper gastrointestinal tract bleeding (U. G. I. B.)has been reviewed. The effect of routine fiberoptic gastroscopy, selective angiography, and selective pitressin arterial infusion has been analyzed as it effects the more accurate diagnosis and better non-operative therapy of these dangerously ill patients. Duodenal and gastric ulcer, which comprise one-half of such patients, are best treated by early operation. Mallory-Weiss-syndrome is more frequent than previously appreciated. Pitressin infusion is worthy of trial in diffuse gastritis, varicose- and stress ulcer bleeding. Stress bleeding is usually one manifestation of multiple organ failure due to bacterial sepsis.

Duodenal Neoplasms↗
PubMed1976

Diagnosis of Mallory-Weiss lesions. A common cause of upper gastrointestinal bleeding.

Mallory-Weiss lesions were considered to be the source of bleeding 21 (13.4%) of 157 unselected patients admitted to a general medical unit because of suspected upper gastrointestinal haemorrhage over a period of 30 months. They represented 16.7% of the 126 patients in whom there was ultimately good evidence of upper gastrointestinal blood-loss. In the total series of 200 suspected bleeding episodes the incidence was 11.5%. It is suggested that endoscopy of the upper gastrointestinal tract, peformed as early as possible after resuscitation, enables the diagnosis of the Mallory-Weiss lesion to be made, shows that it is a relatively common source of haemorrhage, and establishes whether bleeding has stopped, thereby helping to identify patients who can be managed without transfusion and those who are likely to require surgery.

Adult↗
PubMed1977

Emergency diagnosis of upper gastrointestinal bleeding by fiberoptic endoscopy.

Emergency esophagogastroduodenoscopy has been performed in 192 consecutive patients admitted with massive gastrointestinal bleeding. Accurate endoscopic diagnosis was made in 184 or 96%; 58 patients underwent emergency operations to control bleeding with an overall operative mortality of 26%. Excluding 16 patients who underwent emergency portacaval shunting, the operative mortality was 7%. In 6 patients, the bleeding was controlled by endoscopic electrocoagulation. There were no complications. Emergency endoscopy should be done routinely as the primary diagnostic approach in the diagnosis of upper gastrointestinal bleeding.

Adult↗
PubMed1979

Intraarterial vasopressin infusion for treatment of Mallory-Weiss tears of the esophagogastric junction.

Five patients with refractory gastrointestinal bleeding from Mallory-Weiss tears of the esophagus were successfully treated with intraarterial infusions of vasopressin. Although transcatheter embolization has been shown to control the hemorrhage from these lesions, increased experience with and ease of vasopressin infusion suggest that infusion therapy should be the primary treatment method when more conservative measures are inadequate. Embolization techniques may be reserved for cases in which vasopressin therapy is contraindicated or unsuccessful.

Catheterization↗
PubMed1977

[Treatment of peptic ulcer with histamine H2 receptor antagonists].

Histamine H2-receptor antagonists (Burimamide, Metiamide and Cimetidine as the most recent generation) may drastically inhibit gastric acid secretion stimulated by histamine, pentagastrin, insulin, 2-deoxyglucose or an intragastrically instilled meal, respectively. This inhibitory action may explain the beneficial effects of H2-antagonists in the treatment of active peptic ulceration. On Cimetidine administered at a usual dosage over a 4--6 week period, serious side-effects must not be expected. At present studies aim to establish a Cimetidine dosage which, on long-term treatment, may reduce ulcer recurrency.

Burimamide↗