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Circumferential distribution and location of Mallory-Weiss tears: recent trends.

Okada M, Ishimura N, Shimura S, Mikami H, Okimoto E, Aimi M, Uno G, Oshima N, Yuki T, Ishihara S, Kinoshita Y - Endosc Int Open (2015)

Bottom Line: Risk factors for blood transfusion were a longer laceration (odds ratio [OR] 2.3) and a location extending from the esophagus to the stomach (OR 5.3).MWTs were frequently found on the right lateral wall (2 - to 4-o'clock position) of the esophagus aligned with the lesser curvature of the stomach, irrespective of etiology.Longer lacerations extending from the esophagus to the gastric cardia were associated with an elevated risk for bleeding and requirement for blood transfusion.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan.

ABSTRACT

Background and study aims: Mallory-Weiss tears (MWTs) are not only a common cause of acute nonvariceal gastrointestinal bleeding but also an iatrogenic adverse event related to endoscopic procedures. However, changes in the clinical characteristics and endoscopic features of MWTs over the past decade have not been reported. The aim of this study was to investigate recent trends in the etiology and endoscopic features of MWTs.

Patients and methods: We retrospectively reviewed the medical records of patients with a diagnosis of MWT at our university hospital between August 2003 and September 2013. The information regarding etiology, clinical parameters, endoscopic findings, therapeutic interventions, and outcome was reviewed.

Results: A total of 190 patients with MWTs were evaluated. More than half (n = 100) of the cases occurred during endoscopic procedures; cases related to alcohol consumption were less frequent (n = 13). MWTs were most frequently located in the lesser curvature of the stomach and right lateral wall (2 - to 4-o'clock position) of the esophagus, irrespective of the cause. The condition of more than 90 % of the patients (n = 179) was improved by conservative or endoscopic treatment, whereas 11 patients (5.8 %) required blood transfusion. Risk factors for blood transfusion were a longer laceration (odds ratio [OR] 2.3) and a location extending from the esophagus to the stomach (OR 5.3).

Conclusions: MWTs were frequently found on the right lateral wall (2 - to 4-o'clock position) of the esophagus aligned with the lesser curvature of the stomach, irrespective of etiology. Longer lacerations extending from the esophagus to the gastric cardia were associated with an elevated risk for bleeding and requirement for blood transfusion.

No MeSH data available.


Related in: MedlinePlus

 Based on their location, the Mallory-Weiss tears were divided into three groups according to Zeifer’s classification: group I, lacerations only in the esophagus (a); group II, lacerations limited to the stomach (b); group III, lacerations extending from the esophagus across the cardia into the stomach (c).
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FI220-1:  Based on their location, the Mallory-Weiss tears were divided into three groups according to Zeifer’s classification: group I, lacerations only in the esophagus (a); group II, lacerations limited to the stomach (b); group III, lacerations extending from the esophagus across the cardia into the stomach (c).

Mentions: The endoscopic findings were assessed by a single expert endoscopist (M.O.). Based on their location, the MWTs were divided into three groups according to Zeifer’s classification: group I, lacerations only in the esophagus; group II, lacerations limited to the stomach; group III, lacerations extending from the esophagus across the cardia into the stomach (Fig. 1) 17. The number and location of the mucosal lacerations, and the length of the MWTs, were recorded. When multiple lacerations were present in a single patient, the circumferential and longitudinal locations of all the lacerations were counted.


Circumferential distribution and location of Mallory-Weiss tears: recent trends.

Okada M, Ishimura N, Shimura S, Mikami H, Okimoto E, Aimi M, Uno G, Oshima N, Yuki T, Ishihara S, Kinoshita Y - Endosc Int Open (2015)

 Based on their location, the Mallory-Weiss tears were divided into three groups according to Zeifer’s classification: group I, lacerations only in the esophagus (a); group II, lacerations limited to the stomach (b); group III, lacerations extending from the esophagus across the cardia into the stomach (c).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4612247&req=5

FI220-1:  Based on their location, the Mallory-Weiss tears were divided into three groups according to Zeifer’s classification: group I, lacerations only in the esophagus (a); group II, lacerations limited to the stomach (b); group III, lacerations extending from the esophagus across the cardia into the stomach (c).
Mentions: The endoscopic findings were assessed by a single expert endoscopist (M.O.). Based on their location, the MWTs were divided into three groups according to Zeifer’s classification: group I, lacerations only in the esophagus; group II, lacerations limited to the stomach; group III, lacerations extending from the esophagus across the cardia into the stomach (Fig. 1) 17. The number and location of the mucosal lacerations, and the length of the MWTs, were recorded. When multiple lacerations were present in a single patient, the circumferential and longitudinal locations of all the lacerations were counted.

Bottom Line: Risk factors for blood transfusion were a longer laceration (odds ratio [OR] 2.3) and a location extending from the esophagus to the stomach (OR 5.3).MWTs were frequently found on the right lateral wall (2 - to 4-o'clock position) of the esophagus aligned with the lesser curvature of the stomach, irrespective of etiology.Longer lacerations extending from the esophagus to the gastric cardia were associated with an elevated risk for bleeding and requirement for blood transfusion.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan.

ABSTRACT

Background and study aims: Mallory-Weiss tears (MWTs) are not only a common cause of acute nonvariceal gastrointestinal bleeding but also an iatrogenic adverse event related to endoscopic procedures. However, changes in the clinical characteristics and endoscopic features of MWTs over the past decade have not been reported. The aim of this study was to investigate recent trends in the etiology and endoscopic features of MWTs.

Patients and methods: We retrospectively reviewed the medical records of patients with a diagnosis of MWT at our university hospital between August 2003 and September 2013. The information regarding etiology, clinical parameters, endoscopic findings, therapeutic interventions, and outcome was reviewed.

Results: A total of 190 patients with MWTs were evaluated. More than half (n = 100) of the cases occurred during endoscopic procedures; cases related to alcohol consumption were less frequent (n = 13). MWTs were most frequently located in the lesser curvature of the stomach and right lateral wall (2 - to 4-o'clock position) of the esophagus, irrespective of the cause. The condition of more than 90 % of the patients (n = 179) was improved by conservative or endoscopic treatment, whereas 11 patients (5.8 %) required blood transfusion. Risk factors for blood transfusion were a longer laceration (odds ratio [OR] 2.3) and a location extending from the esophagus to the stomach (OR 5.3).

Conclusions: MWTs were frequently found on the right lateral wall (2 - to 4-o'clock position) of the esophagus aligned with the lesser curvature of the stomach, irrespective of etiology. Longer lacerations extending from the esophagus to the gastric cardia were associated with an elevated risk for bleeding and requirement for blood transfusion.

No MeSH data available.


Related in: MedlinePlus