Mallory-Weiss syndrome

Mallory-Weiss syndrome Mallory-Weiss syndrome is characterized by upper digestive hemorrhage, haematemesis, secondary lesions of gastro-esophageal junction gastrice.Cauzele dilacerare of esophageal mucosa are angry: gastro-esophageal reflux disease, recurrent vomiting, acute distension of the lower esophagus, hiatal hernia, chronic hiccups or chronic coughing that increase pressure and cause regurgitation of gastric contents repeated food acid in the esophagus. Affected persons will present with vomiting of food and eliminate undigested or partially digested blood-haematemesis in coffee grounds, after periods of reflux, chronic cough or hiccup. Bleeding stops spontaneously in 80-90% of patients with appropriate therapy most lesions heal within 48 hours. Variaza.Proportia amount of blood lost by patients who required blood transfusion is 40-70%. Haemodynamic instability and cardiovascular shock may occur in 10% of cazuri.Mortalitatea can reach up to 8%. Is used for diagnostic upper endoscopy, which allows direct visualization of the bleeding area.
Causes The hiatal hernia is a predisposing factor found in 35-100% of precipitating pacienti.Factorii include: hiccups, vomiting, chronic cough, CPR, abdominal trauma. In a few cases can not be identified triggers.
Signs and symptoms Classic clinical presentation consists of the following episodes of haematemesis sughit.Hematemeza vomiting or is present at less than 85% of pacienti.Simptome encountered are: faecal occult blood-digested by the externalization of anal blood, black as oil and flavor , syncope, and abdominal pain. Ingestion of alcohol has been reported in 40-75% of cases, and the aspirin in 30%. May be obvious signs of anemia, cardiovascular shock, tachycardia in massive haematemesis.
Diagnosis Laboratory studies include: -Endoscopy allows direct visualization of the cause-bleeding Blood-tests, hematocrit, hemoglobin for anemia revealing -Platelet count, bleeding time, activated partial thromboplastin time-to emphasize clotting disorders Blood for possible transfusion-group -Tests, imaging studies with barium or gastrografin
Treatment In most cases Mallory-Weiss syndrome does not require treatment, stopping bleeding spontan.Daca can not stop using these processes: Endoscopy-epinephrine injection site lesions, it has an effect vasoconstrictor Heat-coagulation of the blood vessel bleeding by endoscopy Arteriography-to-highlight bleeding arteries and injection of vasopressin - Injection of sclerosing agents such as alcohol and polidocanol, tissue necrosis and perforation risks are Argon-laser coagulation Endoscopy-artery ligation Pressure-clipped. Surgery is reserved for cases refractory to endoscopic procedures.
Medications include: -Antacids, proton pump inhibitors, antihistaminiceH2 Mucosal-protective-sucralfate: the mucosa forms an adhesive that acts as a physical barrier against acid -Agents-prochlorperazine antiemetic