Mallory-Weiss
Left/Center: A linear mucosal laceration caused by the force of
vomiting, generally at or just below the esophagogastric junction, resulting in
bleeding. Seen here is an elliptical-shaped mucosal tear which has stopped
bleeding, from the forward view (on the left) and from the retroflexed position
(on the right).
Right: 66 year-old women with a self-induced, intraprocedural
Mallory-Weiss caused by retching during the exam. Bleeding was self-limited;
shown here are fresh blood coating mucosa, and the clot forming at the point of
bleeding just below the esophagogastric junction, seen at retroflexion.
Left: This thin linear mucosal tear is seen on a retroflexed view,
looking back up at the esophagogastric junction. Center: Close up of the
mucosal tear from the photo at left, showing the separation of the mucosa. Right:
Deep, wide mucosal tear beginning just above the squamocolumnar junction,
extending rightward in this photo, in a 51 year-old man presenting with
hematemesis (vomiting blood). Bleeding was self-limited once the vomiting was
brought under control.
Left: 41 year-old man with hematemesis (vomiting blood). Endoscopy
demonstrated a linear mucosal tear extending through the squamocolumnar
junction, with an adherent clot. Center: Fresh clot on a mucosal tear in
a 24 year-old man who presented with severe anemia and hematemesis. Viewed at
retroflexion. Right: Adherent clot and oozing of blood from a mucosal
tear in an 89 year-old woman with hematemesis and a concurrently bleeding
duodenal ulcer.
Left:42 year-old woman presenting with hematemesis (vomiting blood).
Endoscopy demonstrated a linear ulcer (see arrows at center), at the
distal (lower) end of which was an adherent "sentinel" clot, denoting
the site of recent bleeding. The lesion spans the junction of squamous and
columnar mucosa at the esophagogastric junction; the clot resides on the gastric
side.
Right: Iatrogenic Mallory-Weiss which developed during balloon dilation
of a stricture in the distal esophagus. Despite the width of the mucosal tear,
there were no adverse sequellae, and the patient's dysphagia was significantly
improved.