There have been many reports regarding complications associated with cardiopulmonary resuscitation(CPR) and it may be true that there are many unrevealed complications. Although it is used to say that 'any CPR is better than no CPR', inadvertent or inadequate CPR may insult in serious organ injury. This report describes a 64-year-old woman who suffered Mallory-Weiss tear resulting from inadvertent cardiopulmonary resuscitation by a bystander who had never been trained. Possible mechanisms of gastric injuries caused by CPR are suggested, and importance of adequate CPR training are emphasized in this report.
Cardiopulmonary Resuscitation* ; Female ; Humans ; Mallory-Weiss Syndrome* ; Middle Aged

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Male ; Mallory-Weiss Syndrome

Mallory-Weiss tearing (MWT) is a common cause of non-variceal upper gastrointestinal bleeding. Although the majority of patients with bleeding MWT require no intervention other than hemodynamic supports, spectrum of MWT is wide, and the condition sometimes results in a fatal outcome. Endoscopic management to stop the bleeding may be required during the index endoscopy, especially in those with active bleeding or stigmata of recurrent bleeding. Most commonly used endoscopic treatment for actively bleeding MWT is injection therapy, argon plasma coagulation, hemoclip placement, and band ligation. Selection of the optimal endoscopic hemostasis depends on the physician's ability and patient's clinical status.
Argon Plasma Coagulation ; Christianity ; Endoscopy ; Fatal Outcome ; Hemodynamics ; Hemorrhage ; Hemostasis, Endoscopic ; Humans ; Ligation ; Mallory-Weiss Syndrome*

Mallory-Weiss syndrome is a laceration in the region of the gastroesophageal junction due to vomiting, retching, coughing preceding hematemesis in alcoholic patient. Bleeding from Malloly-Weise tears stop spontaneously without specific therapy in 80-90% of patient, but rebleeding occurs in 2 to 5% of patients. Thus most patients require only supportive care. Rarely endoscopic therapy or operative therapy may be required. We performed endoscopic mucosal ligation using intraluminal negative pressure with band ligation for uncontrolled Mallory-Weiss syndrome. In conclusion, Endoscopic O-ring band ligation in uncontrolled intractable Mallory-Weiss syndrome is safe and effective method, but its important that accurate endoscopic O-ring band ligation an bleeding site in laceration area. We experienced endoscopic O-ring band ligation in 6 cases of Mallory-Weiss syndrome.
Alcoholics ; Cough ; Esophagogastric Junction ; Hematemesis ; Hemorrhage ; Humans ; Lacerations ; Ligation* ; Mallory-Weiss Syndrome ; Vomiting

Mallory-Weiss syndrome is a laceration in the region of the gastroesophageal junction due to vomiting, retching, coughing preceding hematemesis in alcoholic patient. Bleeding from Mallory-Weiss tears stop spontaneously without specific therapy in 80-90 percent of patient, but rebleeding is uncommonly occurring in 2 to 5 percent of patients. Thus most patients require only supportive care. Rarely endoscopic therapy or operative therapy may be required. We conducted an uncontrolled study to evaluate an improved metallic clip(Olympus hemoclip) for the endoscopic treatment of Mallory-Weiss syndrome. Initial hemostasis was achieved in all patients with active bleeding. No complications resulted from this treatment. Clips did not impair healing of teared mucosa. We conclude that endoscopic hemoclip placement is a highly effective and safe method for treating uncontrolled Mallory-Weis syndrome.
Alcoholics ; Cough ; Esophagogastric Junction ; Hematemesis ; Hemorrhage ; Hemostasis ; Humans ; Lacerations ; Mallory-Weiss Syndrome ; Mucous Membrane ; Vomiting

BACKGROUND/AIMS: Mallory-Weiss syndrome refers to a laceration or lacerations in the region of the gastroesophageal junction due to vomiting, retching, or coughing induced by several causes, and preceding hematemesis. In the last several years, endoscopic therapies have dramatically changed the need for emergency surgery in patients with upper gastrointestinal bleeding. There is only little information however, regarding the indication criteria and the efficacy of endoscopic therapies in severe upper gastrointestinal bleeding, due to Mallory-Weiss syndrome. This study was designed to assess the usefulness and the indications of endoscopic O-ring band ligation. METHODS: Thirty patients with Mallory- Weiss syndrome who were experiencing a related hemorrhage were studied. Among these, 5 patients with active bleeding or a visible vessel revealed during an endoscopic examination were treated with O-ring band ligation. Patients with blood clots or linear tears received only conservative treatment.
Cough ; Emergencies ; Esophagogastric Junction ; Hematemesis ; Hemorrhage ; Humans ; Lacerations ; Ligation* ; Mallory-Weiss Syndrome ; Vomiting

BACKGROUND/AIMS: Although the majority of patients with Mallory-Weiss syndrome (MWS) have a benign course, MWS patients with recurrent bleeding have an unfavorable outcome and require intensive care. Therefore, this study was carried out to identify the risk factors for recurrent bleeding in MWS patients. METHODS: The medical records of patients with MWS between January 1999 and December 2003, were reviewed retrospectively. Demographics, initial clinical and laboratory parameters, and endoscopic findings of the patients with and without recurrent bleeding were compared and the potential risk factors predicting recurrent bleeding in MWS were evaluated. RESULTS: A total of one hundred and fifty-nine patients (22 women, 137 men, mean age 48.1 years old) were enrolled in the study. Recurrent bleeding was observed in 17 patients (10.7%). Those patients with recurrent bleeding showed higher frequency for the presence of shock at initial manifestation, combined liver cirrhosis and endoscopic findings of active bleeding, lower hemoglobin level and platelet count, higher amount of transfusions and epinephrine-mixed fluid injections, and longer hospital stay than those patients without recurrent bleeding. Significant risk factors predicting the recurrent bleeding in MWS were the presence of shock at initial manifestation (OR 3.71, 95% CI 1.07-14.90) and the evidence of active bleeding on endoscopic examination (OR 9.89, 95% CI 1.88-51.98) on multivariate analysis. CONCLUSIONS: Intensive care with close monitoring is required for the patients with shock on initial manifestation or with evidence of active bleeding on endoscopic examinations since these are independent risk factors predicting the recurrent bleeding in MWS patients.
Female ; Gastrointestinal Hemorrhage/*etiology ; Humans ; Male ; Mallory-Weiss Syndrome/*complications/pathology/therapy ; Middle Aged ; Recurrence

Reflex gasping when hanging leads to passive and vigorous vomiting, the mechanical force of which causes gastric mucosa laceration. Mallory-Weiss syndrome is a tear in the gastro-esophageal junction or its adjacent mucosa, and this can occur due to nausea or vomiting that is caused by various etiologic factors. Gastric fundus is the most common site of gastric mucosa lacerations. We report a case of a 41-year-old man, who tried to hang himself and, as a result, caused multiple gastric mucosa lacerations that were treated by an endoscopic hemostatic procedure in the emergency room.
Adult ; Emergencies ; Gastric Fundus ; Gastric Mucosa ; Humans ; Lacerations ; Mallory-Weiss Syndrome ; Mucous Membrane ; Nausea ; Reflex ; Vomiting

BACKGROUND/AIMS: The detection of iatrogenic Mallory-Weiss syndrome during the course of upper GI endoscopy is apparently rare. The aim of this study was identify the clinical features of the disease and associated medical conditions. METHODS: We retrospectively analyzed 46 cases (0.08%) of iatrogenic Mallory- Weiss syndrome identified from 54,188 consecutive upper GI endoscopies performed at our institution during a period of 85 months. RESULTS: A total of 36 patients (78.2%) had retching or belching during the procedure. Hiatal hernias were noted in 20 patients (43.5%). We identified a difference of the attack rate by sex and age for iatrogenic Mallory-Weiss syndrome; the disorder developed predominantly in men. All of the patients had a mucosal tear and oozing and 16 patients underwent endoscopic hemostasis. After being diagnosed with iatrogenic Mallory-Weiss syndrome, 17 patients underwent follow- up endoscopy and all of the patients showed good results without rebleeding. No patient showed a complicated clinical course. CONCLUSIONS: A small number of patients had iatrogenic Mallory-Weiss syndrome and most of the patients showed a good prognosis. If there is a predictable risk factor identified during an upper GI endoscopy or an associated medical condition, special care needs to be taken to minimize belching or retching.
Endoscopy ; Eructation ; Hemostasis, Endoscopic ; Hernia, Hiatal ; Humans ; Male ; Mallory-Weiss Syndrome ; Prognosis ; Retrospective Studies ; Risk Factors

Dissection intramural hematoma of the esophagus (DIHO) is a rare, but well-documented condition that is part of the spectrum of acute esophageal injuries; these include the more common Mallory-Weiss tear and Boerhaave's syndrome. This disorder is predominantly seen in women during their sixth or seventh decade and the disease has various etiologies, but the pathogenesis has yet to be clarified. The triad of symptoms for this disorder includes retrosternal pain, hematemesis and odynophagia. It is important to differentiate esophageal submucosal dissection form other disorders that have a similar appearance, such as Mallory-Weiss syndrome and esophageal perforation because the prognosis of DIHO is excellent with conservative therapy and these other diseases require surgical treatment. We report here on a case of a dissecting intramural hematoma of the esophagus that was preoperatively misdiagnosed as the submucosal tumor of the esophagus preoperatively, and it was confirmed by Video-assisted thoracic surgery.
Esophageal Perforation ; Esophagus ; Female ; Hematemesis ; Hematoma ; Humans ; Mallory-Weiss Syndrome ; Mediastinal Diseases ; Prognosis