Diagnosis, Clinical Course, and Endoscopic Therapy in Mallory-Weiss Syndrome

Background and Aims: Mallory-Weiss syndrome is responsible for upper gastrointestinal bleeding with a 1%-4% frequency. Most patients with Mallory-Weiss syndrome have a clinically mild course and do not require specific endoscopic treatment. However, some patients with Mallory-Weiss syndrome have severe bleeding. Endoscopic treatment of Mallory-Weiss syndrome is not standardized when compared with that of bleeding ulcers. Here we aim to share our patients’ demographic properties, applied endoscopic treatments, and clinical courses of patients. Materials and Methods: We researched our patients with Mallory-Weiss syndrome in Türkiye Yüksek ？htisas Training and Research Hospital Endoscopic Unit between 2010 and 2017. Results: Overall, 37 patients (males/females: 29/8, mean age: 63.4±19.4 years) were included in the study. Mallory-Weiss syndrome occurred in 15 patients in whom routine endoscopic procedures were performed. Stigmata of active bleeding were observed in 27 patients. Primary hemostasis was achieved in 25 patients with 92.5% frequency. Endoscopic procedures including placement of hemoclips, injection of epinephrine, and thermocoagulation with a heater probe were performed in patients with stigmata of active bleeding. Patients were divided into two groups depending on whether the origin of Mallory-Weiss syndrome was iatrogenic. Hospital stays, erythrocyte transfusion rates, primary hemostasis, stigmata of active bleeding, and frequencies of hiatal hernia were compared between the two groups. There were no differences between the two groups. Placement of hemoclips was performed in 27 patients; 19 patients received hemoclips alone whereas 8 patients received hemoclips with epinephrine injections. Mortality was not observed in any of our patients. Conclusion: Although most patients with Mallory-Weiss syndrome have benign clinical courses, it is important to keep in mind that Mallory-Weiss syndrome can be associated with severe bleeding. Hemoclip placement is an effective endoscopic treatment method in Mallory-Weiss syndrome