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gastroscope alongside Dr. Palmer who specifically mentioned the use of an endoscopy for diagnosis of
Mallory–Weiss syndrome, so clinicians would not have to wait for a patient to die before performing an autopsy. However, a common finding between the patients with Decker's analysis is the exacerbation of the lesions caused by vomiting with atrophic gastritis being an underlying factor that to those formations; though it is to be noted that atrophic gastritis is a condition that is common with the elderly population which most of the 11 patients undergoing an autopsy were above 60 years of age. Moving forward to 1955, advances in surgery allow for a patient afflicted with Mallory–Weiss syndrome to be identified, then treated with the surgical procedure with Dr. E. Gale Whiting & Dr. Gilbert Baronne, when the only way in the past was to perform an autopsy when a patient is deceased. The following year, Hardy per the recommendations of Palmer and Decker was able to complete the first diagnosis of the syndrome via endoscopy, leading to an increased incidence of Mallory–Weiss syndrome as shown with over 200 cases being mentioned in the literature as of 1973, and eventually the standard to make use of endoscopy to diagnosis the condition to witness lacerations along the esophageal lining and the signs of hemorrhage.
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coordinate the cardiac opening of the stomach with the contraction of the abdominal muscles to induce the vomiting. Years later, Weiss and
Mallory performed autopsies on 4 patients that died due to the complications of the syndrome caused by the hemorrhage. With the autopsies, it was noted that patients had lesions that were present on the esophagus down to the junction of the esophagus that meets the stomach. These particular lesions had signs of continual exposure to gastric juices from the stomach caused by the vomiting due to the pressure imbalances from the stomach; as a result the acutely formed lesions developed into chronic ulcerative lesions that ran deep into the layers of the esophagus up until the muscle fibers. In addition, there were signs of small arterioles that ruptured and small veins that were near the lesions which explains the hemorrhage that was present in these patients.
459:(such as famotidine) are utilized to manage and lower gastric acidity. Decreasing the acidity through use of proton pump inhibitors and H2 receptor antagonists allows there to be time for healing. Proton pump inhibitors are preferred over H2 receptor antagonists because they are more potent and can keep gastric pH under control for a longer period of time. Furthermore, proton pump inhibitors have a decreased recurrent bleeding rate and do not lose their efficacy as a side effect when taken regularly over time (tachyphylaxis) compared to H2 receptor antagonists. It is recommended that individuals are given proton pump inhibitors within 72 hours of an endoscopy to prevent further GI bleeds. Additionally,
355:. Typically, the tear is located near the top of the stomach's lesser curvature and below the gastroesophageal junction. In the majority of patients, tears usually range from approximately 2 to 4 cm in length. The findings may include indications of non-bleeding, active bleeding, or the presence of clot over the tear. Furthermore, an upper GI endoscopy can reveal underlying conditions that lead to the signs of bleeding secondary to the tears, including varices and ulcers along the upper GI tract. To determine if the patient has active bleedings or signs of chronic alcoholism that can precede Mallory–Weiss syndrome, the patient's lab values would be obtained to get a
359:(CBC) including hematocrit & hemoglobin levels alongside platelet count. Additionally, diagnosis of Mallory-Weiss Syndrome includes elimination of other causes of an upper gastrointestinal bleed and/or bleeding in general. For example, a patient should undergo more labs to determine kidney function via measuring blood urea nitrogen and creatinine as a patient with chronic kidney disease can be mistaken to have active bleeding due to anemia induced by chronic kidney disease or if both the esophageal lacerations and chronic kidney disease are contributing to the low hematocrit & hemoglobin levels.
320:(scaring/fibrosis of the liver) who also had portal hypertension have shown that an increase in portal pressure can cause an increase in intra-abdominal pressure. These increases in intra-abdominal pressure are associated with Mallory-Weiss Syndrome. More severe upper gastrointestinal bleeds are associated with concurrent portal hypertension and esophageal varices. The formation of esophageal varices (dilated veins) is linked to the presence of portal hypertension. Additionally, esophageal varices can rupture which can be fatal.
165:
182:, counting of around 1-15% of all cases in adults and less than 5% in children. It has been found that tears are up to 2 to 4 times more prevalent in men than women. The tears can cause upper gastrointestinal bleeding and predominantly occur where the esophagus meets the stomach (gastroesophageal junction). However, the tears can happen anywhere from the middle of the esophagus to the cardia of the stomach. Mallory–Weiss syndrome is often caused by constant vomiting and retching from
379:
localized, the condition can be managed with conservative treatment methods such as intravenous antacids, antiemetics, fasting, and bedrest. Antiemetics are medications used to help with nausea and vomiting. However, if constant bleeding is observed upon endoscopy, endoscopic hemostasis techniques are necessary as the first-line treatment. Four examples of endoscopic hemostasis techniques are hemoclipping, heat probe thermocoagulation, injection therapy, and band ligation.
141:
22:
203:
was from 1879 when Dr. Heinrich
Quincke discovered 3 cases of bleeding from the formation of ulcers in the gastroesophageal tube; 2 of the cases were fatal due to vomiting of blood. This was followed by 2 cases reported by Dieulafoy to witness death from the phenomenon via vomiting of blood and 100 more cases in later literature before the findings in 1929.
401:
exacerbate bleeding, posing significant risks. It should also be avoided in individuals with portal hypertension because more bleeding can occur. It is also noted that repeated coagulation therapy can lead to risk of transmural injury. Treatment is usually supportive as persistent bleeding after endoscopic treatment or esophagogastroscopy is uncommon.
289:
this study found that hiatial hernias were found in 75% of patients with
Mallory–Weiss syndrome. On the contrary, a case-control study in 2017 found there was no association between hiatal hernias and Mallory–Weiss syndrome. Forceful vomiting causes tearing of the mucosa at the junction. Additionally, the use of
440:
can be used to ligate the bleeding vessel. A Sengstaken-Blakemore tube will not be able to stop bleeding as here the bleeding is arterial and the pressure in the balloon is not sufficient to overcome the arterial pressure. After patient receives appropriate intervention, bleeding must be observed for
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stops the bleeding by applying a direct pressure from a transparent ligation cap. The role of transparent cap is to stabilize the bleeding site and reduce the effects of peristalsis. Band ligation technique is relatively simple compared to other hemostatic techniques. Band ligation is recommended for
378:
The course of treatment and management of
Mallory–Weiss syndrome depends on the amount of bleeding or hematemesis. Although blood transfusion is ultimately needed for many patients with Mallory–Weiss syndrome, 90% of Mallory-Weiss tears can heal on their own spontaneously. If the bleeding is mild and
334:
There have been a few complications from invasive procedures such as trans-esophageal echocardiography and upper gastrointestinal endoscopy that cause
Mallory-Weiss tears called iatrogenic Mallory–Weiss syndrome. However, it is infrequent since it only occurs in 0.07% to 0.49% of individuals who have
251:
is most commonly associated with gastrointestinal bleeding. Furthermore, gastrointestinal losses, such as those incurred from prolonged vomiting or diarrhea are associated with non-hemorrhagic hypovolemic shock. Both hemorrhagic and non-hemorrhagic hypovolemic shock can occur when there are decreases
246:
treatment may be necessary for severe bleeds. In cases of more severe bleeding, the typical symptoms of
Mallory-Weiss Syndrome are those typical found in shock, which can be life-threatening. If a patient does happen to go into shock it may be reversed if discovered early. Although there are multiple
218:
Dr. John Decker also examined patients afflicted with
Mallory–Weiss syndrome via autopsy to note that many of patients did not have a history of alcoholism unlike the initial study conducted by the physicians the syndrome is named after; though Decker did comment that patients could be examined via
338:
Furthermore, there were some cases reported of individuals developing
Mallory-Weiss tears after cardiopulmonary resuscitation (CPR). The individuals did not have a history of alcoholism, hiatal hernia, or gastrointestinal diseases, but woke up vomiting blood. A GI endoscopy was performed and tears
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could be a predisposing condition to developing
Mallory–Weiss syndrome. There is conflicting data suggesting the association between hiatal hernias and Mallory–Weiss syndrome. In 1989, a study conducted in Japan set out to determine if there was a link to Mallory–Weiss syndrome and hiatal hernias,
202:
Before 1929, there were cases reported with similar symptoms of bleeding in the esophagus, the first being Johann Friedrich Hermann Albers reporting ulcer in the lower esophagus in 1833 via autopsy; however those were caused by ulcers and not lacerations. Another instance of Mallory–Weiss syndrome
385:
is an effective method for treating Mallory-Weiss tears because it uses small metal clips, which cause minimal tissue damage and stop the bleeding by clipping the affected blood vessels. Although hemoclip placement is a convenient procedure for nonfibrotic tissue, such as Mallory–Weiss syndrome,
214:
who accurately characterized the condition as a lower esophageal laceration in 1929 in 15 patients afflicted with alcoholism who presented with signs and symptoms of vomiting and retching. It was hypothesized that repeated vomiting would lead to the formation of tears if the body was not able to
475:– Full thickness esophageal ruptures are also often secondary to vomiting/retching. It is important to differentiate Boerhaave syndrome from Mallory-Weiss Syndrome as both condition involve damage to the esophagus, but Boerhaave syndrome specifically involves a transmural esophageal perforation.
417:
to stop the bleeding through vasoconstriction may be undertaken during the index endoscopy procedure in the case of active and recurrent bleeding. Because it is easy to implement and widely available, such injection methods to stop bleeding are commonly used. However, this method requires close
400:
can be employed to cauterize tissue. It is most appropriate for small and localized lesions that requires minimal cauterization. However, it should be avoided in patients with esophageal varices as the absence of a serosal layer in the esophagus increases susceptibility to perforation and could
235:), and a history of retching may be absent. Oftentimes, hematemesis is accompanied by chest, back, or epigastric pain. Additional symptoms can occur depending on how severe the condition is. Some individuals have experienced dizziness, loss of consciousness, and upper abdomen pain.
190:. Gastroesophageal reflux disease (GERD) is another risk factor that is often linked with Mallory–Weiss syndrome. However, not every individual with Mallory–Weiss syndrome will have these risk factors. Individuals with Mallory–Weiss syndrome will have
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297:, are known to increase the risk of upper gastrointestinal bleeding. NSAIDs can increase the risk of upper gastrointestinal bleeding because they can cause further damage to the intestinal submucosa by inhibiting prostaglandin synthesis.
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It is also thought that Mallory–Weiss syndrome can be caused by actions that cause sudden increases in intra-abdominal pressure, such as repeated severe vomiting or coughing. There is some conflicting evidence that the presence of a
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is one of the endoscopic therapy used to stop bleeding by simultaneously applying heat and pressure directly on the area of the active bleed to start the coagulation. Thermocoagulation with bipolar or multipolar
252:
in intravascular volume, such as when the body is hemorrhaging (bleeding) or significant fluid loss. This decrease in intravascular volume causes subsequent reflex mechanism produced by the body to activate
418:
monitoring due to the possibility of causing ventricular tachycardia when administered submucosally. Thus, epinephrine injections should not be used in patients who have existing cardiovascular conditions.
177:
is a condition where high intra-abdominal pressures causes laceration and bleeding of the mucosa called Mallory-Weiss tears. Additionally, Mallory–Weiss syndrome is one of the most common causes of acute
1364:
Escorsell A, Ginès A, Llach J, García-Pagán JC, Bordas JM, Bosch J, et al. (October 2002). "Increasing intra-abdominal pressure increases pressure, volume, and wall tension in esophageal varices".
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which involves all the layers). Most patients are between the ages of 30 and 50 years, although it has been reported in infants aged as young as 3 weeks, as well as in older people.
256:(sympathetic nervous system) in the later stages of hypovolemic shock. SANs is activated in response to the drop in mean arterial pressure that is brought on by the loss of fluid.
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2450:
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Corral JE, Keihanian T, Kröner PT, Dauer R, Lukens FJ, Sussman DA (April 2017). "Mallory Weiss syndrome is not associated with hiatal hernia: a matched case-control study".
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If a patient is thought to have shock, intravenous (IV) fluid resuscitation should begin immediately. In the case of hypovolemic shock, patients are typically placed in the
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807:
Decker JP, Zamcheck N, Mallory GK (December 1953). "Mallory-Weiss syndrome: hemorrhage from gastroesophageal lacerations at the cardiac orifice of the stomach".
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were found on the esophagogastric junction and lesser curvature of the stomach. An increase in intragastric pressure during CPR caused the Mallory-Weiss tears.
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position where the feet are above the head. Additionally, if there is found to be a active bleed treatment with PRBCs (packed red blood cells) is typical.
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The condition is rarely fatal since in 90% of cases the tears heal on their own and the bleeding will stop spontaneously within 48 to 72 hours. However,
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Parva M, Finnegan M, Keiter C, Mercogliano G, Perez CM (August 2009). "Mallory-Weiss tear diagnosed in the immediate postpartum period: a case report".
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Some other options to stop bleeding include ethanol injections, ε-aminocaproic acid, or Argon plasma coagulation (APC). When endoscopy is ineffective,
316:. Portal hypertension is where there is increased pressure within the venous portal system. Additionally, studies that were preformed in patients with
899:
Lee SH, Yoon C, Chai DG, Bae KI, Kang SW, Kim JH, et al. (April 2006). "Mallory-Weiss syndrome: retrospective review of ten years' experience".
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1490:"[Clinical study of Mallory-Weiss syndrome in the aged patients over 75 year--mainly five cases induced by the endoscopic examination]"
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Proper history taking by the medical doctor to distinguish other conditions that cause haematemesis but definitive diagnosis is by conducting
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481:(GERD) - Chronic gastrointestinal disorder that affects the lower esophageal sphincter and transient lower esophageal sphincter relaxations.
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that cause long term nausea and vomiting could be a factor. Other potential risks for GI bleeds are usage of anticoagulants and older age.
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2203:"Proton pump inhibitors therapy vs H2 receptor antagonists therapy for upper gastrointestinal bleeding after endoscopy: A meta-analysis"
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331:, which is severe morning sickness associated with vomiting and retching in pregnancy, is also a known cause of Mallory–Weiss tear.
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placing a hemoclip can be challenging at the typical location of Mallory-Weiss tears at the gastroesophageal junction.
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Yin A, Li Y, Jiang Y, Liu J, Luo H (June 2012). "Mallory-Weiss syndrome: clinical and endoscopic characteristics".
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of the arteries supplying the region may be required to stop the bleeding. If all other methods fail, high
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Additionally, bleeding from Mallory-Weiss tears is often associated with individuals who have a history of
280:). Specifically, up to 75% of patients have been observed with a heavy alcohol use associated with emesis.
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such as promethazine are given to control nausea and vomiting as part of the treatment regimen.
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1939:"Endoscopic clipping for gastrointestinal bleeding: emergency and prophylactic indications"
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231:) after violent retching or vomiting, but may also be noticed as old blood in the stool (
1999:
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The tear involves the mucosa and submucosa but not the muscular layer (contrast to
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abuse is also a rare association. In rare instances some chronic disorders like
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Mallory–Weiss tear affecting the esophageal side of the gastroesophageal junction
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1986:
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Mallory–Weiss syndrome often presents as an episode of vomiting up blood (
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15:
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received the upper gastrointestinal endoscopy procedure.
134:
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653:
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1864:
1621:
1505:
1250:
998:
988:
875:
753:
106:Learn how and when to remove this message
1783:American Gastroenterological Association
1680:Shaikh H, Hashmi MF, Aeddula NR (2024),
1231:British Journal of Clinical Pharmacology
1154:Scandinavian Journal of Gastroenterology
1122:Nehring SM, Chen RJ, Freeman AM (2024).
1070:Minerva Dietologica E Gastroenterologica
545:Tanabe S, Saigenji K (September 1998).
532:
455:(such as omeprazole, pantoprazole) and
276:, and gastroesophageal reflux disease (
206:Mallory–Weiss syndrome was named after
2279:Antunes C, Aleem A, Curtis SA (2024),
1807:Ahlawat R, Hoilat GJ, Ross AB (2024).
1276:Revista de Gastroenterologia de Mexico
977:Gastroenterology Research and Practice
2817:Small intestinal bacterial overgrowth
2168:European Journal of Internal Medicine
1849:"Mallory-Weiss Syndrome in Pregnancy"
514:Non-steroidal anti-inflammatory drugs
7:
1571:Journal of Clinical Gastroenterology
1331:Oliver TI, Sharma B, John S (2024).
648:
646:
644:
642:
44:adding citations to reliable sources
2024:Morales P, Baum AE (January 2003).
2000:10.1146/annurev.me.38.020187.001411
842:Holmes D, Keith M (November 1966).
809:The New England Journal of Medicine
547:"[Mallory-Weiss syndrome]"
441:at least 48 hours as a follow-up.
14:
3702:Spontaneous bacterial peritonitis
3549:Exocrine pancreatic insufficiency
2281:"Gastroesophageal Reflux Disease"
2207:World Journal of Gastroenterology
1682:"Anemia of Chronic Renal Disease"
3447:Secondary sclerosing cholangitis
2068:Current Gastroenterology Reports
1583:10.1097/00004836-199010000-00016
1467:10.1046/j.1442-2050.1999.00006.x
1243:10.1046/j.0306-5251.2001.01220.x
860:10.1097/00000658-196611000-00004
791:10.1001/jama.1932.02730420011005
20:
2688:Gastric antral vascular ectasia
2683:Portal hypertensive gastropathy
2560:Gastroesophageal reflux disease
1752:. November 2004. Archived from
1719:. December 2006. Archived from
613:Rawla P, Devasahayam J (2024).
479:Gastroesophageal reflux disease
180:upper gastrointestinal bleeding
31:needs additional citations for
3442:Primary sclerosing cholangitis
3292:Hepatic veno-occlusive disease
3114:Solitary rectal ulcer syndrome
1035:Haseer Koya H, Paul M (2024).
702:10.1080/00325481.1984.11698826
451:In pharmacological treatment,
1:
3499:Sphincter of Oddi dysfunction
1775:"What is Upper GI Endoscopy?"
1750:National Institutes of Health
1543:10.1016/S1701-2163(16)34280-3
1166:10.1080/00365521.2016.1267793
667:10.1016/S0009-9260(73)80127-8
3408:Postcholecystectomy syndrome
2927:Intestinal pseudoobstruction
2535:Esophageal motility disorder
1906:10.18773/austprescr.2020.011
1866:10.25077/jom.7.2.98-112.2022
1809:"Esophagogastroduodenoscopy"
1779:Patient Center -- Procedures
1659:10.1016/0002-9610(81)90425-6
1403:Marcelle M, Attia M (2024).
247:types of shock, hemorrhagic
1647:American Journal of Surgery
948:10.1007/978-3-319-40646-6_7
821:10.1056/NEJM195312102492401
3770:
3393:Gallstone / Cholelithiasis
2917:Functional colonic disease
2713:Zollinger–Ellison syndrome
2180:10.1016/j.ejim.2012.02.005
1943:Annals of Gastroenterology
1623:10.1016/j.joad.2015.06.013
1189:Gastroenterologia Japonica
1095:Jain J, Yilanli M (2024).
901:Gastrointestinal Endoscopy
364:esophagogastroduodenoscopy
2594:Acute esophageal necrosis
2131:10.1186/s13167-016-0056-4
2080:10.1007/s11894-005-0030-0
2042:10.1007/s11938-003-0036-3
1988:Annual Review of Medicine
1507:10.3143/geriatrics.31.374
1455:Diseases of the Esophagus
1306:American Family Physician
913:10.1016/j.gie.2006.03.217
147:
138:
2693:Gastric dumping syndrome
2568:Laryngopharyngeal reflux
2555:Diffuse esophageal spasm
2220:10.3748/wjg.v21.i20.6341
1610:Journal of Acute Disease
746:10.5946/ce.2015.48.2.102
615:"Mallory-Weiss Syndrome"
55:"Mallory–Weiss syndrome"
3309:Alcoholic liver disease
2842:Bile acid malabsorption
2786:Peptic (duodenal) ulcer
1379:10.1053/jhep.2002.35817
509:H2 receptor antagonists
3319:Hepatic encephalopathy
2703:Buried bumper syndrome
2634:Peptic (gastric) ulcer
2518:Mallory–Weiss syndrome
2461:human digestive system
2417:Mallory–Weiss syndrome
1955:10.20524/aog.2020.0526
1124:"Alcohol Use Disorder"
504:Proton pump inhibitors
491:Hyperemesis gravidarum
457:H2 receptor antagonist
453:Proton pump inhibitors
329:Hyperemesis gravidarum
175:Mallory–Weiss syndrome
126:Mallory–Weiss syndrome
3544:Pancreatic pseudocyst
3413:Porcelain gallbladder
2525:Zenker's diverticulum
1894:Australian Prescriber
1333:"Portal Hypertension"
728:Kim HS (March 2015).
690:Postgraduate Medicine
353:esophagus and stomach
3348:Hepatorenal syndrome
3287:Budd–Chiari syndrome
3244:Autoimmune hepatitis
3069:Intestinal adhesions
2827:Short bowel syndrome
2656:Functional dyspepsia
2574:Esophageal stricture
2540:Nutcracker esophagus
2254:"Boerhaave Syndrome"
1853:Journal of Midwifery
1405:"Esophageal Varices"
990:10.1155/2017/5454791
357:complete blood count
40:improve this article
3744:Esophagus disorders
3487:Choledocholithiasis
3358:Metabolic disorders
3324:Acute liver failure
3297:Portal hypertension
3249:Alcoholic hepatitis
3092:Radiation proctitis
3011:Mesenteric ischemia
2983:Gastroenterocolitis
2812:Blind loop syndrome
2622:Ménétrier's disease
2530:Barrett's esophagus
1373:(4 Pt 1): 936–940.
487:- Vomiting up blood
310:portal hypertension
3662:Undefined location
3653:Grynfeltt–Lesshaft
3554:Pancreatic fistula
3537:Pancreatic abscess
3492:Biliary dyskinesia
3463:Mirizzi's syndrome
2964:Large and/or small
2644:Dieulafoy's lesion
2513:Boerhaave syndrome
2381:External resources
1437:Boerhaave Syndrome
1201:10.1007/BF02774319
734:Clinical Endoscopy
696:(8): 189–95, 198.
655:Clinical Radiology
473:Boerhaave syndrome
325:Boerhaave syndrome
314:esophageal varices
223:Signs and symptoms
208:G. Kenneth Mallory
3726:
3725:
3722:
3721:
3562:
3561:
3164:
3163:
3021:Bowel obstruction
2723:
2722:
2426:
2425:
2213:(20): 6341–6351.
1742:"Upper Endoscopy"
1097:"Bulimia Nervosa"
957:978-3-319-40646-6
848:Annals of Surgery
785:(16): 1353–1355.
496:Ménière's disease
393:thermocoagulation
303:Ménière's disease
249:hypovolemic shock
172:
171:
120:Medical condition
116:
115:
108:
90:
3761:
3714:Pneumoperitoneum
3571:
3481:Common bile duct
3363:Wilson's disease
3353:Peliosis hepatis
3222:
3099:Proctalgia fugax
3006:Abdominal angina
2931:Ogilvie syndrome
2880:Pseudomembranous
2738:
2698:Gastric volvulus
2663:Pyloric stenosis
2474:
2459:Diseases of the
2453:
2446:
2439:
2430:
2308:
2296:
2295:
2276:
2270:
2269:
2249:
2243:
2242:
2232:
2222:
2198:
2192:
2191:
2163:
2154:
2153:
2143:
2133:
2118:The EPMA Journal
2109:
2100:
2099:
2063:
2054:
2053:
2021:
2012:
2011:
1983:
1977:
1976:
1966:
1934:
1928:
1927:
1917:
1885:
1879:
1878:
1868:
1844:
1831:
1830:
1828:
1827:
1804:
1798:
1797:
1795:
1794:
1785:. Archived from
1771:
1765:
1764:
1762:
1761:
1738:
1732:
1731:
1729:
1728:
1709:
1703:
1702:
1701:
1700:
1677:
1671:
1670:
1642:
1636:
1635:
1625:
1601:
1595:
1594:
1566:
1555:
1554:
1526:
1520:
1519:
1509:
1485:
1479:
1478:
1450:
1444:
1433:
1427:
1426:
1424:
1423:
1400:
1391:
1390:
1361:
1355:
1354:
1352:
1351:
1328:
1322:
1321:
1301:
1292:
1291:
1271:
1265:
1264:
1254:
1222:
1213:
1212:
1184:
1178:
1177:
1149:
1140:
1139:
1119:
1113:
1112:
1092:
1086:
1085:
1065:
1059:
1058:
1056:
1055:
1032:
1013:
1012:
1002:
992:
968:
962:
961:
935:
918:
916:
896:
890:
889:
879:
839:
833:
832:
804:
795:
794:
774:
768:
767:
757:
725:
714:
713:
685:
679:
678:
650:
637:
636:
634:
633:
610:
567:
566:
557:(9): 2332–2335.
542:
270:eating disorders
168:
167:
159:Gastroenterology
143:
123:
111:
104:
100:
97:
91:
89:
48:
24:
16:
3769:
3768:
3764:
3763:
3762:
3760:
3759:
3758:
3729:
3728:
3727:
3718:
3683:
3672:Internal hernia
3558:
3503:
3468:Biliary fistula
3426:
3417:
3403:Adenomyomatosis
3398:Cholesterolosis
3374:
3368:Hemochromatosis
3239:Viral hepatitis
3211:
3160:
3118:
3104:Rectal prolapse
3073:
3040:Fecal impaction
3030:Intussusception
2993:Crohn's disease
2959:
2942:Toxic megacolon
2854:
2852:Large intestine
2846:
2791:Curling's ulcer
2744:
2742:Small intestine
2731:
2719:
2627:Gastroenteritis
2598:
2463:
2457:
2427:
2422:
2421:
2376:
2375:
2319:
2305:
2300:
2299:
2278:
2277:
2273:
2251:
2250:
2246:
2200:
2199:
2195:
2165:
2164:
2157:
2111:
2110:
2103:
2065:
2064:
2057:
2023:
2022:
2015:
1985:
1984:
1980:
1936:
1935:
1931:
1887:
1886:
1882:
1846:
1845:
1834:
1825:
1823:
1806:
1805:
1801:
1792:
1790:
1773:
1772:
1768:
1759:
1757:
1740:
1739:
1735:
1726:
1724:
1711:
1710:
1706:
1698:
1696:
1679:
1678:
1674:
1644:
1643:
1639:
1603:
1602:
1598:
1568:
1567:
1558:
1528:
1527:
1523:
1487:
1486:
1482:
1452:
1451:
1447:
1434:
1430:
1421:
1419:
1402:
1401:
1394:
1363:
1362:
1358:
1349:
1347:
1330:
1329:
1325:
1303:
1302:
1295:
1273:
1272:
1268:
1224:
1223:
1216:
1186:
1185:
1181:
1151:
1150:
1143:
1121:
1120:
1116:
1094:
1093:
1089:
1067:
1066:
1062:
1053:
1051:
1034:
1033:
1016:
970:
969:
965:
958:
937:
936:
921:
898:
897:
893:
841:
840:
836:
815:(24): 957–963.
806:
805:
798:
776:
775:
771:
727:
726:
717:
687:
686:
682:
652:
651:
640:
631:
629:
612:
611:
570:
544:
543:
534:
529:
469:
376:
345:
274:bulimia nervosa
262:
225:
200:
162:
121:
112:
101:
95:
92:
49:
47:
37:
25:
12:
11:
5:
3767:
3765:
3757:
3756:
3751:
3746:
3741:
3731:
3730:
3724:
3723:
3720:
3719:
3717:
3716:
3711:
3709:Hemoperitoneum
3706:
3705:
3704:
3693:
3691:
3685:
3684:
3682:
3681:
3680:
3679:
3674:
3669:
3658:
3657:
3656:
3655:
3650:
3637:
3636:
3631:
3626:
3621:
3616:
3615:
3614:
3609:
3598:
3597:
3592:
3591:
3590:
3579:
3577:
3568:
3564:
3563:
3560:
3559:
3557:
3556:
3551:
3546:
3541:
3540:
3539:
3534:
3529:
3524:
3513:
3511:
3505:
3504:
3502:
3501:
3496:
3495:
3494:
3489:
3476:
3475:
3470:
3465:
3456:
3455:
3454:
3449:
3444:
3433:
3431:
3419:
3418:
3416:
3415:
3410:
3405:
3400:
3395:
3390:
3384:
3382:
3376:
3375:
3373:
3372:
3371:
3370:
3365:
3355:
3350:
3345:
3344:
3343:
3338:
3328:
3327:
3326:
3321:
3311:
3306:
3305:
3304:
3299:
3294:
3289:
3277:
3276:
3275:
3265:
3264:
3263:
3253:
3252:
3251:
3246:
3241:
3230:
3228:
3219:
3213:
3212:
3210:
3209:
3208:
3207:
3197:
3196:
3195:
3190:
3180:
3178:Blood in stool
3174:
3172:
3166:
3165:
3162:
3161:
3159:
3158:
3153:
3151:Anal dysplasia
3148:
3143:
3138:
3128:
3126:
3120:
3119:
3117:
3116:
3111:
3106:
3101:
3096:
3095:
3094:
3083:
3081:
3075:
3074:
3072:
3071:
3066:
3065:
3064:
3054:
3053:
3052:
3042:
3037:
3032:
3027:
3018:
3016:Angiodysplasia
3013:
3008:
2997:
2996:
2995:
2985:
2980:
2979:
2978:
2967:
2965:
2961:
2960:
2958:
2957:
2951:Diverticulosis
2947:Diverticulitis
2944:
2935:
2934:
2933:
2924:
2914:
2909:
2908:
2907:
2902:
2897:
2892:
2887:
2882:
2872:
2866:
2864:
2848:
2847:
2845:
2844:
2839:
2837:Milroy disease
2834:
2829:
2824:
2819:
2814:
2809:
2807:Tropical sprue
2804:
2795:
2794:
2793:
2783:
2782:
2781:
2776:
2771:
2760:
2758:
2735:
2729:Lower GI tract
2725:
2724:
2721:
2720:
2718:
2717:
2716:
2715:
2705:
2700:
2695:
2690:
2685:
2680:
2675:
2670:
2665:
2660:
2659:
2658:
2648:
2647:
2646:
2641:
2631:
2630:
2629:
2624:
2619:
2608:
2606:
2600:
2599:
2597:
2596:
2591:
2586:
2581:
2576:
2571:
2565:
2564:
2563:
2557:
2552:
2547:
2542:
2532:
2527:
2522:
2521:
2520:
2515:
2505:
2504:
2503:
2498:
2493:
2482:
2480:
2471:
2469:Upper GI tract
2465:
2464:
2458:
2456:
2455:
2448:
2441:
2433:
2424:
2423:
2420:
2419:
2408:
2397:
2385:
2384:
2382:
2378:
2377:
2374:
2373:
2362:
2351:
2336:
2320:
2315:
2314:
2312:
2311:Classification
2304:
2303:External links
2301:
2298:
2297:
2271:
2244:
2193:
2174:(4): e92–e96.
2155:
2101:
2055:
2013:
1978:
1949:(6): 563–570.
1929:
1880:
1832:
1799:
1766:
1733:
1704:
1672:
1653:(5): 560–562.
1637:
1616:(4): 335–337.
1596:
1577:(5): 569–572.
1556:
1537:(8): 740–743.
1521:
1500:(5): 374–379.
1480:
1445:
1428:
1392:
1356:
1323:
1312:(5): 294–300.
1293:
1266:
1237:(2): 173–181.
1214:
1195:(3): 233–238.
1179:
1160:(4): 462–464.
1141:
1114:
1087:
1072:(in Italian).
1060:
1014:
963:
956:
919:
891:
834:
796:
769:
740:(2): 102–105.
715:
680:
661:(1): 107–112.
638:
568:
531:
530:
528:
525:
524:
523:
522:
521:
516:
511:
506:
498:
493:
488:
482:
476:
468:
465:
398:electrocautery
375:
372:
344:
341:
261:
258:
224:
221:
199:
196:
170:
169:
156:
150:
149:
145:
144:
136:
135:
132:
128:
127:
119:
114:
113:
28:
26:
19:
13:
10:
9:
6:
4:
3:
2:
3766:
3755:
3752:
3750:
3747:
3745:
3742:
3740:
3737:
3736:
3734:
3715:
3712:
3710:
3707:
3703:
3700:
3699:
3698:
3695:
3694:
3692:
3690:
3686:
3678:
3675:
3673:
3670:
3668:
3665:
3664:
3663:
3660:
3659:
3654:
3651:
3649:
3646:
3645:
3644:
3643:
3639:
3638:
3635:
3632:
3630:
3627:
3625:
3622:
3620:
3617:
3613:
3610:
3608:
3605:
3604:
3603:
3600:
3599:
3596:
3593:
3589:
3586:
3585:
3584:
3583:Diaphragmatic
3581:
3580:
3578:
3576:
3572:
3569:
3565:
3555:
3552:
3550:
3547:
3545:
3542:
3538:
3535:
3533:
3530:
3528:
3525:
3523:
3520:
3519:
3518:
3515:
3514:
3512:
3510:
3506:
3500:
3497:
3493:
3490:
3488:
3485:
3484:
3483:
3482:
3478:
3477:
3474:
3471:
3469:
3466:
3464:
3460:
3457:
3453:
3450:
3448:
3445:
3443:
3440:
3439:
3438:
3435:
3434:
3432:
3430:
3424:
3420:
3414:
3411:
3409:
3406:
3404:
3401:
3399:
3396:
3394:
3391:
3389:
3388:Cholecystitis
3386:
3385:
3383:
3381:
3377:
3369:
3366:
3364:
3361:
3360:
3359:
3356:
3354:
3351:
3349:
3346:
3342:
3339:
3337:
3334:
3333:
3332:
3331:Liver abscess
3329:
3325:
3322:
3320:
3317:
3316:
3315:
3314:Liver failure
3312:
3310:
3307:
3303:
3300:
3298:
3295:
3293:
3290:
3288:
3285:
3284:
3283:
3282:
3278:
3274:
3271:
3270:
3269:
3266:
3262:
3259:
3258:
3257:
3254:
3250:
3247:
3245:
3242:
3240:
3237:
3236:
3235:
3232:
3231:
3229:
3227:
3223:
3220:
3218:
3214:
3206:
3203:
3202:
3201:
3198:
3194:
3191:
3189:
3186:
3185:
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2994:
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2989:
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2971:Enterocolitis
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2798:Malabsorption
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2673:Gastroparesis
2671:
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2666:
2664:
2661:
2657:
2654:
2653:
2652:
2649:
2645:
2642:
2640:
2639:Cushing ulcer
2637:
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2584:Megaesophagus
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2018:
2014:
2009:
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1789:on 2007-09-28
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1756:on 2007-10-24
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1723:on 2007-10-06
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454:
449:
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446:Trendelenburg
442:
439:
435:
431:
426:
423:
422:Band ligation
419:
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415:cauterization
412:
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287:
286:hiatal hernia
281:
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78:
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71:
67:
64:
60:
57: –
56:
52:
51:Find sources:
45:
41:
35:
34:
29:This article
27:
23:
18:
17:
3661:
3640:
3517:Pancreatitis
3479:
3429:biliary tree
3302:Nutmeg liver
3279:
3205:Hematochezia
3156:Pruritus ani
3141:Anal abscess
3136:Anal fistula
3132:Anal fissure
3045:Constipation
2999:
2870:Appendicitis
2678:Gastroptosis
2668:Achlorhydria
2517:
2507:
2496:Eosinophilic
2410:
2399:
2388:
2364:
2353:
2338:
2323:
2284:
2274:
2257:
2247:
2210:
2206:
2196:
2171:
2167:
2121:
2117:
2071:
2067:
2036:(1): 75–83.
2033:
2029:
1991:
1987:
1981:
1946:
1942:
1932:
1900:(2): 49–56.
1897:
1893:
1883:
1856:
1852:
1824:. Retrieved
1812:
1802:
1791:. Retrieved
1787:the original
1778:
1769:
1758:. Retrieved
1754:the original
1745:
1736:
1725:. Retrieved
1721:the original
1707:
1697:, retrieved
1685:
1675:
1650:
1646:
1640:
1613:
1609:
1599:
1574:
1570:
1534:
1530:
1524:
1497:
1493:
1483:
1461:(1): 65–67.
1458:
1454:
1448:
1435:
1431:
1420:. Retrieved
1408:
1370:
1366:
1359:
1348:. Retrieved
1336:
1326:
1309:
1305:
1282:(2): 75–77.
1279:
1275:
1269:
1234:
1230:
1192:
1188:
1182:
1157:
1153:
1127:
1117:
1100:
1090:
1073:
1069:
1063:
1052:. Retrieved
1040:
980:
976:
966:
939:
907:(5): AB132.
904:
900:
894:
851:
847:
837:
812:
808:
782:
778:
772:
737:
733:
693:
689:
683:
658:
654:
630:. Retrieved
618:
554:
550:
500:Medications
450:
443:
434:embolization
427:
421:
420:
407:
404:
403:
392:
389:
388:
383:Hemoclipping
382:
381:
377:
361:
346:
337:
333:
322:
307:
282:
263:
237:
226:
217:
205:
201:
174:
173:
117:
102:
96:October 2015
93:
83:
76:
69:
62:
50:
38:Please help
33:verification
30:
3697:Peritonitis
3459:Cholestasis
3437:Cholangitis
3380:Gallbladder
3268:Fatty liver
3188:Hematemesis
3170:GI bleeding
2976:Necrotizing
2905:Lymphocytic
2900:Collagenous
2895:Microscopic
2832:Steatorrhea
2733:Enteropathy
2579:Inlet patch
2501:Herpetiform
2486:Esophagitis
2390:MedlinePlus
1994:: 267–277.
1076:(1): 7–12.
983:: 5454791.
519:Antiemetics
485:Hematemesis
461:antiemetics
438:gastrostomy
430:angiography
410:epinephrine
229:hematemesis
192:hematemesis
131:Other names
3733:Categories
3689:Peritoneal
3667:Incisional
3588:Congenital
3532:Hereditary
3509:Pancreatic
3473:Haemobilia
3146:Hemorrhoid
3124:Anal canal
3062:Infectious
3050:Functional
2885:Ulcerative
2769:Duodenitis
2708:Gastrinoma
2412:Patient UK
2366:DiseasesDB
2285:StatPearls
2258:StatPearls
2074:(3): 175.
1826:2024-07-24
1813:StatPearls
1793:2007-10-07
1760:2007-10-07
1727:2007-10-07
1699:2024-08-01
1686:StatPearls
1422:2024-07-25
1409:StatPearls
1367:Hepatology
1350:2024-07-24
1337:StatPearls
1128:StatPearls
1101:StatPearls
1054:2024-07-25
1041:StatPearls
854:(5): 810.
632:2024-07-23
619:StatPearls
527:References
390:Heat probe
266:alcoholism
240:endoscopic
212:Soma Weiss
184:alcoholism
66:newspapers
3754:Syndromes
3677:Richter's
3634:Spigelian
3629:Obturator
3619:Umbilical
3452:Ascending
3423:Bile duct
3256:Cirrhosis
3234:Hepatitis
3217:Accessory
3087:Proctitis
2938:Megacolon
2912:Dysentery
2822:Whipple's
2774:Jejunitis
2764:Enteritis
2651:Dyspepsia
2612:Gastritis
2545:Achalasia
2478:Esophagus
2401:eMedicine
2096:195343875
2050:1534-309X
1875:2598-3180
1859:(2): 98.
1632:2221-6189
1442:eMedicine
868:0003-4932
405:Injection
374:Treatment
349:endoscopy
343:Diagnosis
318:cirrhosis
295:ibuprofen
154:Specialty
3749:Vomiting
3607:Indirect
3602:Inguinal
3336:Pyogenic
3281:Vascular
3057:Diarrhea
3035:Volvulus
3001:Vascular
2940: /
2929: /
2890:Ischemic
2857:Appendix
2747:Duodenum
2617:Atrophic
2491:Candidal
2406:ped/1359
2293:28722967
2266:28613559
2239:26034370
2188:22560400
2150:26998186
2124:(1): 7.
2088:15913474
1973:33162733
1924:32346211
1821:30335301
1694:30969693
1551:19772708
1475:10941865
1417:28846255
1387:12297841
1345:29939540
1318:32109037
1261:11851641
1174:28007004
1136:28613774
1109:32965849
1049:30285387
1009:28348579
829:13111391
764:25844336
627:30855778
467:See also
368:duodenum
272:such as
244:surgical
3648:Petit's
3624:Femoral
3527:Chronic
3341:Amoebic
3109:Anismus
2875:Colitis
2802:Coeliac
2779:Ileitis
2751:Jejunum
2604:Stomach
2508:Rupture
2360:D008309
2230:4445112
2141:4799841
2008:3555295
1964:7599350
1915:7186277
1667:7304810
1591:2230001
1516:8072208
1288:2287873
1252:1874281
1209:2744343
1082:2657497
1037:"Shock"
1000:5350415
886:5923104
877:1477108
755:4381135
710:6334289
675:4579296
563:9780715
351:of the
198:History
188:bulimia
80:scholar
3642:Lumbar
3612:Direct
3595:Hiatus
3575:Hernia
3427:Other
3193:Melena
3079:Rectum
2562:(GERD)
2395:000269
2291:
2264:
2237:
2227:
2186:
2148:
2138:
2094:
2086:
2048:
2006:
1971:
1961:
1922:
1912:
1873:
1819:
1692:
1665:
1630:
1589:
1549:
1514:
1473:
1415:
1385:
1343:
1316:
1286:
1259:
1249:
1207:
1172:
1134:
1107:
1080:
1047:
1007:
997:
954:
884:
874:
866:
827:
762:
752:
708:
673:
625:
561:
291:NSAIDs
260:Causes
233:melena
161:
82:
75:
68:
61:
53:
3567:Other
3522:Acute
3273:MASLD
3226:Liver
3200:Lower
3183:Upper
3025:Ileus
2861:Colon
2755:Ileum
2570:(LPR)
2349:530.7
2334:K22.6
2092:S2CID
299:NSAID
87:JSTOR
73:books
2955:SCAD
2371:7803
2355:MeSH
2344:9-CM
2289:PMID
2262:PMID
2235:PMID
2184:PMID
2146:PMID
2084:PMID
2046:ISSN
2004:PMID
1969:PMID
1920:PMID
1871:ISSN
1817:PMID
1717:BUPA
1690:PMID
1663:PMID
1628:ISSN
1587:PMID
1547:PMID
1512:PMID
1471:PMID
1413:PMID
1383:PMID
1341:PMID
1314:PMID
1284:PMID
1257:PMID
1205:PMID
1170:PMID
1132:PMID
1105:PMID
1078:PMID
1045:PMID
1005:PMID
981:2017
952:ISBN
882:PMID
864:ISSN
825:PMID
760:PMID
706:PMID
671:PMID
623:PMID
559:PMID
312:and
278:GERD
254:SANs
210:and
59:news
3261:PBC
2988:IBD
2922:IBS
2340:ICD
2325:ICD
2225:PMC
2215:doi
2176:doi
2136:PMC
2126:doi
2076:doi
2038:doi
1996:doi
1959:PMC
1951:doi
1910:PMC
1902:doi
1861:doi
1655:doi
1651:142
1618:doi
1579:doi
1539:doi
1502:doi
1463:doi
1440:at
1375:doi
1310:101
1247:PMC
1239:doi
1197:doi
1162:doi
995:PMC
985:doi
944:doi
909:doi
872:PMC
856:doi
852:164
817:doi
813:249
787:doi
750:PMC
742:doi
698:doi
663:doi
432:or
413:or
408:of
242:or
186:or
42:by
3735::
3425:/
3023::
3004::
2800::
2415::
2404::
2393::
2369::
2358::
2347::
2332::
2329:10
2283:,
2256:.
2233:.
2223:.
2211:21
2209:.
2205:.
2182:.
2172:23
2170:.
2158:^
2144:.
2134:.
2120:.
2116:.
2104:^
2090:.
2082:.
2070:.
2058:^
2044:.
2032:.
2028:.
2016:^
2002:.
1992:38
1990:.
1967:.
1957:.
1947:33
1945:.
1941:.
1918:.
1908:.
1898:43
1896:.
1892:.
1869:.
1855:.
1851:.
1835:^
1811:.
1781:.
1777:.
1748:.
1744:.
1715:.
1684:,
1661:.
1649:.
1626:.
1612:.
1608:.
1585:.
1575:12
1573:.
1559:^
1545:.
1535:31
1533:.
1510:.
1498:31
1496:.
1492:.
1469:.
1459:12
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