Mallory-Weiss syndrome--revisted.

Six patients (three women and three men) who had upper gastrointestinal hemorrhage due to Mallory-Weiss syndrome are described. Retching was the most common precipitating factor (5/6) followed by vomiting (2/6). Basic underlying causes for either retching or vomiting were probable excess alcohol consumption (3/6), side-effects of oral or parentral medication (2/6) and over-indulgence in eating after partial gastrectomy (1/6). The two most important factors leading to confirmation of the diagnosis were: 1. History of events prior to the onset of upper gastrointestinal hemorrhage and 2. early panendoscopy. One noted feature of the present series is the high incidence of other silent co-existing pathological lesions at the time of endoscopic examination. Upper gastrointestinal hemorrhage was characterized as mild to moderate (300-500 cc.) in three patients and moderate to severe (1,000-2,000 cc.) in another three patients. All recovered under medical management and none required surgical intervention. It is becoming increasingly evident that such a benign outcome in Mallory-Weiss syndrome is more common than previously recognized.