Document Detail

Clinical and endoscopic risk factors in the Mallory-Weiss syndrome.
MedLine Citation:
PMID:  9149189     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Although patients with bleeding Mallory-Weiss tears are generally hospitalized, we wished to develop guidelines facilitating the selection, by clinical and endoscopic criteria, of patients who do not need hospitalization. Our specific aims were to determine whether presenting manifestations of bleeding differed in hemodynamically unstable patients, whether active bleeding or stigmata of bleeding at endoscopy were prognosticators for significant rebleeding, and the outcomes in endoscopically managed patients. METHODS: The endoscopic and clinical features of all patients with acute GI bleeding from a Mallory-Weiss tear were obtained from our GI Bleeding Team database over a consecutive 4-yr period and analyzed for prognostic indicators. RESULTS: 1) Presenting manifestations, e.g., hematochezia, were significantly different in hypotensive patients. 2) Active bleeding but not stigmata was associated with higher transfusion requirements. 3) Rebleeding was unusual, occurring within 24 h, more often in patients with a bleeding/coagulation diathesis. The median hospital stay was 4 days (range 1-24). Fifty-seven percent of patients received transfusion (median 4 units, range 1-26 units); requirements were higher in patients with coagulopathies. CONCLUSIONS: Patients without risk factors for rebleeding (portal hypertension, coagulopathy), clinical features indicating severe bleeding (hematochezia, hemodynamic instability), or active bleeding at endoscopy can be managed with a brief period of observation. Patients with endoscopically active bleeding may benefit from endoscopic therapy.
A E Bharucha; C J Gostout; R K Balm
Related Documents :
8926909 - Warfarin--topical salicylate interactions: case reports.
17579159 - Value of "patent track" sign on doppler sonography after percutaneous liver biopsy in d...
18221609 - Treatment of gastropathy and gastric antral vascular ectasia in patients with portal hy...
21286849 - Trace elements analysis of urine and hair in tuberculous pleurisy.
16510029 - Pharmacologic therapy for gastrointestinal bleeding due to portal hypertension and esop...
23311349 - Headache in hemifacial spasm patients.
2961409 - Speech timing in parkinson's and huntington's disease.
11020019 - Lp(a) is increased in hemodialysis patients according to the type of dialysis membrane:...
23205229 - Nasal and exhaled nitric oxide in allergic rhinitis.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  92     ISSN:  0002-9270     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  1997 May 
Date Detail:
Created Date:  1997-05-28     Completed Date:  1997-05-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  805-8     Citation Subset:  IM    
Division of Gastroenterology and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Aged, 80 and over
Endoscopy, Digestive System
Gastrointestinal Hemorrhage / etiology,  therapy
Mallory-Weiss Syndrome / complications*,  etiology*,  pathology,  therapy
Middle Aged
Predictive Value of Tests
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Mucosa-associated lymphoid tissue (MALT) in Barrett's esophagus: prospective evaluation and associat...
Next Document:  Randomized, controlled comparison of two forms of preparation for screening flexible sigmoidoscopy.