In 1929, Kenneth Mallory and Soma Weiss first described a syndrome characterized by esophageal bleeding caused by a mucosal tear in the esophagus as a result of forceful vomiting or retching. The initial description was associated with alcoholic binging; however, with the advent of endoscopy, Mallory-Weiss tears have been diagnosed in many patients with no antecedent history of alcohol intake. The tear typically occurs after repeated episodes of vomiting or retching, but it may occur after a single incident.
Although most written reports of these tears relate to adults, Mallory-Weiss tears also occur in children.
In pediatrics, Mallory-Weiss tears are recognized in children with predisposing medical conditions, including portal hypertension, liver cirrhosis, and severe gastroesophageal reflux disease. The clinical implications in these pediatric patients are noteworthy, especially because these children are predisposed to recurrent upper GI bleeding.
The associated risk of morbidity and mortality must also be underscored.
Examples of Mallory-Weiss tears are shown in the images below.
Mallory-Weiss tear. Typical longitudinal mucosal tear with overlying fibrinous exudate extending from the distal esophagus to the gastric cardia. Courtesy of C.J. Gostout, MD.
Mallory-Weiss tear. Retroflexed view of the cardia showing the typical location of the tear with a clean base.