A Study on Clinical Characteristics of Mallory-Weiss Syndrome with Complicated Course

Lee, Hang Lak; Han, Dong Soo; Kim, Jong Pyo; Kim, Jin Bae; Park, Joon Yong; Sohn, Joo Hyun; Hahm, Joon Soo

Abstract

BACKGROUND/AIMS
Mallory-Weiss syndrome is a benign and self-limiting disease, but occasionally cases with complications are encountered. The aim of this study was to identify the risk factors for complicated course and predisposing factors of Mallory-Weiss syndrome, and its associated conditions.
METHODS
Fifty-nine patients diagnosed as having Mallory-Weiss syndrome were subjects of this study. Patients' medical records were reviewed retrospectively. A complicated course was defined if there was a need for transfusion of > 6 pints, evidence of shock, rebleeding or angiographic or surgical interventions.
RESULTS
Risk factors for a complicated Mallory-Weiss syndrome in univariate analysis were the followings; low hemoglobin, melena, presence of visible vessel or active bleeding on initial endoscopy. In multivariate analysis, the presence of visible vessel and active bleeding on initial endoscopy were the only significant risk factors. Predisposing factors of Mallory-Weiss syndrome were as follows: vomiting after alcohol intake (62.7%), vomiting without alcohol (18.6%), nausea (1%), cough (1%), seizure (1%) and unknown etiology (13.6%). Associated medical conditions were as follows: alcoholic liver disease (45.8%), hiatal hernia (27.1%) and liver cirrhosis (18.6%).
CONCLUSIONS
We suggest that the presence of visible vessel and active bleeding on initial endoscopy are a independent risk factors of Mallory-Weiss syndrome with a complicated course. In such patients, aggressive treatment and careful observations are essential.