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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.
470:(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,
366:. 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
370:(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.
331:(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.
176:
193:, 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
390:
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.
152:
33:
214:
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.
412:
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.
300:
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
451:
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
389:
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
345:
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
262:
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
257:
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
229:
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
349:
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,
213:
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
396:
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,
225:
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
486:– 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.
428:
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
411:
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
246:), 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.
201:. 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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308:, 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.
294:
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
406:
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
263:
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
429:
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.
188:
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
1375:
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.
267:(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.
3749:
2461:
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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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818:
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,
1540:
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,
327:. Portal hypertension is where there is increased pressure within the venous portal system. Additionally, studies that were preformed in patients with
910:
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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Proper history taking by the medical doctor to distinguish other conditions that cause haematemesis but definitive diagnosis is by conducting
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492:(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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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
291:). 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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2010:
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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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Mallory–Weiss syndrome often presents as an episode of vomiting up blood (
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1973:
1924:
1875:
1632:
1516:
1261:
1009:
999:
886:
764:
117:Learn how and when to remove this message
1794:American Gastroenterological Association
1691:Shaikh H, Hashmi MF, Aeddula NR (2024),
1242:British Journal of Clinical Pharmacology
1165:Scandinavian Journal of Gastroenterology
1133:Nehring SM, Chen RJ, Freeman AM (2024).
1081:Minerva Dietologica E Gastroenterologica
556:Tanabe S, Saigenji K (September 1998).
543:
466:(such as omeprazole, pantoprazole) and
287:, and gastroesophageal reflux disease (
217:Mallory–Weiss syndrome was named after
2290:Antunes C, Aleem A, Curtis SA (2024),
1818:Ahlawat R, Hoilat GJ, Ross AB (2024).
1287:Revista de Gastroenterologia de Mexico
988:Gastroenterology Research and Practice
2828:Small intestinal bacterial overgrowth
2179:European Journal of Internal Medicine
1860:"Mallory-Weiss Syndrome in Pregnancy"
525:Non-steroidal anti-inflammatory drugs
7:
1582:Journal of Clinical Gastroenterology
1342:Oliver TI, Sharma B, John S (2024).
659:
657:
655:
653:
55:adding citations to reliable sources
2035:Morales P, Baum AE (January 2003).
2011:10.1146/annurev.me.38.020187.001411
853:Holmes D, Keith M (November 1966).
820:The New England Journal of Medicine
558:"[Mallory-Weiss syndrome]"
452:at least 48 hours as a follow-up.
25:
3713:Spontaneous bacterial peritonitis
3560:Exocrine pancreatic insufficiency
2292:"Gastroesophageal Reflux Disease"
2218:World Journal of Gastroenterology
1693:"Anemia of Chronic Renal Disease"
3458:Secondary sclerosing cholangitis
2079:Current Gastroenterology Reports
1594:10.1097/00004836-199010000-00016
1478:10.1046/j.1442-2050.1999.00006.x
1254:10.1046/j.0306-5251.2001.01220.x
871:10.1097/00000658-196611000-00004
802:10.1001/jama.1932.02730420011005
31:
2699:Gastric antral vascular ectasia
2694:Portal hypertensive gastropathy
2571:Gastroesophageal reflux disease
1763:. November 2004. Archived from
1730:. December 2006. Archived from
624:Rawla P, Devasahayam J (2024).
490:Gastroesophageal reflux disease
191:upper gastrointestinal bleeding
42:needs additional citations for
3453:Primary sclerosing cholangitis
3303:Hepatic veno-occlusive disease
3125:Solitary rectal ulcer syndrome
1046:Haseer Koya H, Paul M (2024).
713:10.1080/00325481.1984.11698826
462:In pharmacological treatment,
1:
3510:Sphincter of Oddi dysfunction
1786:"What is Upper GI Endoscopy?"
1761:National Institutes of Health
1554:10.1016/S1701-2163(16)34280-3
1177:10.1080/00365521.2016.1267793
678:10.1016/S0009-9260(73)80127-8
3419:Postcholecystectomy syndrome
2938:Intestinal pseudoobstruction
2546:Esophageal motility disorder
1917:10.18773/austprescr.2020.011
1877:10.25077/jom.7.2.98-112.2022
1820:"Esophagogastroduodenoscopy"
1790:Patient Center -- Procedures
1670:10.1016/0002-9610(81)90425-6
1414:Marcelle M, Attia M (2024).
258:types of shock, hemorrhagic
1658:American Journal of Surgery
959:10.1007/978-3-319-40646-6_7
832:10.1056/NEJM195312102492401
3781:
3404:Gallstone / Cholelithiasis
2928:Functional colonic disease
2724:Zollinger–Ellison syndrome
2191:10.1016/j.ejim.2012.02.005
1954:Annals of Gastroenterology
1634:10.1016/j.joad.2015.06.013
1200:Gastroenterologia Japonica
1106:Jain J, Yilanli M (2024).
912:Gastrointestinal Endoscopy
375:esophagogastroduodenoscopy
2605:Acute esophageal necrosis
2142:10.1186/s13167-016-0056-4
2091:10.1007/s11894-005-0030-0
2053:10.1007/s11938-003-0036-3
1999:Annual Review of Medicine
1518:10.3143/geriatrics.31.374
1466:Diseases of the Esophagus
1317:American Family Physician
924:10.1016/j.gie.2006.03.217
158:
149:
2704:Gastric dumping syndrome
2579:Laryngopharyngeal reflux
2566:Diffuse esophageal spasm
2231:10.3748/wjg.v21.i20.6341
1621:Journal of Acute Disease
757:10.5946/ce.2015.48.2.102
626:"Mallory-Weiss Syndrome"
66:"Mallory–Weiss syndrome"
3320:Alcoholic liver disease
2853:Bile acid malabsorption
2797:Peptic (duodenal) ulcer
1390:10.1053/jhep.2002.35817
520:H2 receptor antagonists
3330:Hepatic encephalopathy
2714:Buried bumper syndrome
2645:Peptic (gastric) ulcer
2529:Mallory–Weiss syndrome
2472:human digestive system
2428:Mallory–Weiss syndrome
1966:10.20524/aog.2020.0526
1135:"Alcohol Use Disorder"
515:Proton pump inhibitors
502:Hyperemesis gravidarum
468:H2 receptor antagonist
464:Proton pump inhibitors
340:Hyperemesis gravidarum
186:Mallory–Weiss syndrome
137:Mallory–Weiss syndrome
3555:Pancreatic pseudocyst
3424:Porcelain gallbladder
2536:Zenker's diverticulum
1905:Australian Prescriber
1344:"Portal Hypertension"
739:Kim HS (March 2015).
701:Postgraduate Medicine
364:esophagus and stomach
3359:Hepatorenal syndrome
3298:Budd–Chiari syndrome
3255:Autoimmune hepatitis
3080:Intestinal adhesions
2838:Short bowel syndrome
2667:Functional dyspepsia
2585:Esophageal stricture
2551:Nutcracker esophagus
2265:"Boerhaave Syndrome"
1864:Journal of Midwifery
1416:"Esophageal Varices"
1001:10.1155/2017/5454791
368:complete blood count
51:improve this article
3755:Esophagus disorders
3498:Choledocholithiasis
3369:Metabolic disorders
3335:Acute liver failure
3308:Portal hypertension
3260:Alcoholic hepatitis
3103:Radiation proctitis
3022:Mesenteric ischemia
2994:Gastroenterocolitis
2823:Blind loop syndrome
2633:Ménétrier's disease
2541:Barrett's esophagus
1384:(4 Pt 1): 936–940.
498:- Vomiting up blood
321:portal hypertension
3673:Undefined location
3664:Grynfeltt–Lesshaft
3565:Pancreatic fistula
3548:Pancreatic abscess
3503:Biliary dyskinesia
3474:Mirizzi's syndrome
2975:Large and/or small
2655:Dieulafoy's lesion
2524:Boerhaave syndrome
2392:External resources
1448:Boerhaave Syndrome
1212:10.1007/BF02774319
745:Clinical Endoscopy
707:(8): 189–95, 198.
666:Clinical Radiology
484:Boerhaave syndrome
336:Boerhaave syndrome
325:esophageal varices
234:Signs and symptoms
219:G. Kenneth Mallory
18:Mallory-Weiss tear
3737:
3736:
3733:
3732:
3573:
3572:
3175:
3174:
3032:Bowel obstruction
2734:
2733:
2437:
2436:
2224:(20): 6341–6351.
1753:"Upper Endoscopy"
1108:"Bulimia Nervosa"
968:978-3-319-40646-6
859:Annals of Surgery
796:(16): 1353–1355.
507:Ménière's disease
404:thermocoagulation
314:Ménière's disease
260:hypovolemic shock
183:
182:
131:Medical condition
127:
126:
119:
101:
16:(Redirected from
3772:
3725:Pneumoperitoneum
3582:
3492:Common bile duct
3374:Wilson's disease
3364:Peliosis hepatis
3233:
3110:Proctalgia fugax
3017:Abdominal angina
2942:Ogilvie syndrome
2891:Pseudomembranous
2749:
2709:Gastric volvulus
2674:Pyloric stenosis
2485:
2470:Diseases of the
2464:
2457:
2450:
2441:
2319:
2307:
2306:
2287:
2281:
2280:
2260:
2254:
2253:
2243:
2233:
2209:
2203:
2202:
2174:
2165:
2164:
2154:
2144:
2129:The EPMA Journal
2120:
2111:
2110:
2074:
2065:
2064:
2032:
2023:
2022:
1994:
1988:
1987:
1977:
1945:
1939:
1938:
1928:
1896:
1890:
1889:
1879:
1855:
1842:
1841:
1839:
1838:
1815:
1809:
1808:
1806:
1805:
1796:. Archived from
1782:
1776:
1775:
1773:
1772:
1749:
1743:
1742:
1740:
1739:
1720:
1714:
1713:
1712:
1711:
1688:
1682:
1681:
1653:
1647:
1646:
1636:
1612:
1606:
1605:
1577:
1566:
1565:
1537:
1531:
1530:
1520:
1496:
1490:
1489:
1461:
1455:
1444:
1438:
1437:
1435:
1434:
1411:
1402:
1401:
1372:
1366:
1365:
1363:
1362:
1339:
1333:
1332:
1312:
1303:
1302:
1282:
1276:
1275:
1265:
1233:
1224:
1223:
1195:
1189:
1188:
1160:
1151:
1150:
1130:
1124:
1123:
1103:
1097:
1096:
1076:
1070:
1069:
1067:
1066:
1043:
1024:
1023:
1013:
1003:
979:
973:
972:
946:
929:
927:
907:
901:
900:
890:
850:
844:
843:
815:
806:
805:
785:
779:
778:
768:
736:
725:
724:
696:
690:
689:
661:
648:
647:
645:
644:
621:
578:
577:
568:(9): 2332–2335.
553:
281:eating disorders
179:
178:
170:Gastroenterology
154:
134:
122:
115:
111:
108:
102:
100:
59:
35:
27:
21:
3780:
3779:
3775:
3774:
3773:
3771:
3770:
3769:
3740:
3739:
3738:
3729:
3694:
3683:Internal hernia
3569:
3514:
3479:Biliary fistula
3437:
3428:
3414:Adenomyomatosis
3409:Cholesterolosis
3385:
3379:Hemochromatosis
3250:Viral hepatitis
3222:
3171:
3129:
3115:Rectal prolapse
3084:
3051:Fecal impaction
3041:Intussusception
3004:Crohn's disease
2970:
2953:Toxic megacolon
2865:
2863:Large intestine
2857:
2802:Curling's ulcer
2755:
2753:Small intestine
2742:
2730:
2638:Gastroenteritis
2609:
2474:
2468:
2438:
2433:
2432:
2387:
2386:
2330:
2316:
2311:
2310:
2289:
2288:
2284:
2262:
2261:
2257:
2211:
2210:
2206:
2176:
2175:
2168:
2122:
2121:
2114:
2076:
2075:
2068:
2034:
2033:
2026:
1996:
1995:
1991:
1947:
1946:
1942:
1898:
1897:
1893:
1857:
1856:
1845:
1836:
1834:
1817:
1816:
1812:
1803:
1801:
1784:
1783:
1779:
1770:
1768:
1751:
1750:
1746:
1737:
1735:
1722:
1721:
1717:
1709:
1707:
1690:
1689:
1685:
1655:
1654:
1650:
1614:
1613:
1609:
1579:
1578:
1569:
1539:
1538:
1534:
1498:
1497:
1493:
1463:
1462:
1458:
1445:
1441:
1432:
1430:
1413:
1412:
1405:
1374:
1373:
1369:
1360:
1358:
1341:
1340:
1336:
1314:
1313:
1306:
1284:
1283:
1279:
1235:
1234:
1227:
1197:
1196:
1192:
1162:
1161:
1154:
1132:
1131:
1127:
1105:
1104:
1100:
1078:
1077:
1073:
1064:
1062:
1045:
1044:
1027:
981:
980:
976:
969:
948:
947:
932:
909:
908:
904:
852:
851:
847:
826:(24): 957–963.
817:
816:
809:
787:
786:
782:
738:
737:
728:
698:
697:
693:
663:
662:
651:
642:
640:
623:
622:
581:
555:
554:
545:
540:
480:
387:
356:
285:bulimia nervosa
273:
236:
211:
173:
132:
123:
112:
106:
103:
60:
58:
48:
36:
23:
22:
15:
12:
11:
5:
3778:
3776:
3768:
3767:
3762:
3757:
3752:
3742:
3741:
3735:
3734:
3731:
3730:
3728:
3727:
3722:
3720:Hemoperitoneum
3717:
3716:
3715:
3704:
3702:
3696:
3695:
3693:
3692:
3691:
3690:
3685:
3680:
3669:
3668:
3667:
3666:
3661:
3648:
3647:
3642:
3637:
3632:
3627:
3626:
3625:
3620:
3609:
3608:
3603:
3602:
3601:
3590:
3588:
3579:
3575:
3574:
3571:
3570:
3568:
3567:
3562:
3557:
3552:
3551:
3550:
3545:
3540:
3535:
3524:
3522:
3516:
3515:
3513:
3512:
3507:
3506:
3505:
3500:
3487:
3486:
3481:
3476:
3467:
3466:
3465:
3460:
3455:
3444:
3442:
3430:
3429:
3427:
3426:
3421:
3416:
3411:
3406:
3401:
3395:
3393:
3387:
3386:
3384:
3383:
3382:
3381:
3376:
3366:
3361:
3356:
3355:
3354:
3349:
3339:
3338:
3337:
3332:
3322:
3317:
3316:
3315:
3310:
3305:
3300:
3288:
3287:
3286:
3276:
3275:
3274:
3264:
3263:
3262:
3257:
3252:
3241:
3239:
3230:
3224:
3223:
3221:
3220:
3219:
3218:
3208:
3207:
3206:
3201:
3191:
3189:Blood in stool
3185:
3183:
3177:
3176:
3173:
3172:
3170:
3169:
3164:
3162:Anal dysplasia
3159:
3154:
3149:
3139:
3137:
3131:
3130:
3128:
3127:
3122:
3117:
3112:
3107:
3106:
3105:
3094:
3092:
3086:
3085:
3083:
3082:
3077:
3076:
3075:
3065:
3064:
3063:
3053:
3048:
3043:
3038:
3029:
3027:Angiodysplasia
3024:
3019:
3008:
3007:
3006:
2996:
2991:
2990:
2989:
2978:
2976:
2972:
2971:
2969:
2968:
2962:Diverticulosis
2958:Diverticulitis
2955:
2946:
2945:
2944:
2935:
2925:
2920:
2919:
2918:
2913:
2908:
2903:
2898:
2893:
2883:
2877:
2875:
2859:
2858:
2856:
2855:
2850:
2848:Milroy disease
2845:
2840:
2835:
2830:
2825:
2820:
2818:Tropical sprue
2815:
2806:
2805:
2804:
2794:
2793:
2792:
2787:
2782:
2771:
2769:
2746:
2740:Lower GI tract
2736:
2735:
2732:
2731:
2729:
2728:
2727:
2726:
2716:
2711:
2706:
2701:
2696:
2691:
2686:
2681:
2676:
2671:
2670:
2669:
2659:
2658:
2657:
2652:
2642:
2641:
2640:
2635:
2630:
2619:
2617:
2611:
2610:
2608:
2607:
2602:
2597:
2592:
2587:
2582:
2576:
2575:
2574:
2568:
2563:
2558:
2553:
2543:
2538:
2533:
2532:
2531:
2526:
2516:
2515:
2514:
2509:
2504:
2493:
2491:
2482:
2480:Upper GI tract
2476:
2475:
2469:
2467:
2466:
2459:
2452:
2444:
2435:
2434:
2431:
2430:
2419:
2408:
2396:
2395:
2393:
2389:
2388:
2385:
2384:
2373:
2362:
2347:
2331:
2326:
2325:
2323:
2322:Classification
2315:
2314:External links
2312:
2309:
2308:
2282:
2255:
2204:
2185:(4): e92–e96.
2166:
2112:
2066:
2024:
1989:
1960:(6): 563–570.
1940:
1891:
1843:
1810:
1777:
1744:
1715:
1683:
1664:(5): 560–562.
1648:
1627:(4): 335–337.
1607:
1588:(5): 569–572.
1567:
1548:(8): 740–743.
1532:
1511:(5): 374–379.
1491:
1456:
1439:
1403:
1367:
1334:
1323:(5): 294–300.
1304:
1277:
1248:(2): 173–181.
1225:
1206:(3): 233–238.
1190:
1171:(4): 462–464.
1152:
1125:
1098:
1083:(in Italian).
1071:
1025:
974:
967:
930:
902:
845:
807:
780:
751:(2): 102–105.
726:
691:
672:(1): 107–112.
649:
579:
542:
541:
539:
536:
535:
534:
533:
532:
527:
522:
517:
509:
504:
499:
493:
487:
479:
476:
409:electrocautery
386:
383:
355:
352:
272:
269:
235:
232:
210:
207:
181:
180:
167:
161:
160:
156:
155:
147:
146:
143:
139:
138:
130:
125:
124:
39:
37:
30:
24:
14:
13:
10:
9:
6:
4:
3:
2:
3777:
3766:
3763:
3761:
3758:
3756:
3753:
3751:
3748:
3747:
3745:
3726:
3723:
3721:
3718:
3714:
3711:
3710:
3709:
3706:
3705:
3703:
3701:
3697:
3689:
3686:
3684:
3681:
3679:
3676:
3675:
3674:
3671:
3670:
3665:
3662:
3660:
3657:
3656:
3655:
3654:
3650:
3649:
3646:
3643:
3641:
3638:
3636:
3633:
3631:
3628:
3624:
3621:
3619:
3616:
3615:
3614:
3611:
3610:
3607:
3604:
3600:
3597:
3596:
3595:
3594:Diaphragmatic
3592:
3591:
3589:
3587:
3583:
3580:
3576:
3566:
3563:
3561:
3558:
3556:
3553:
3549:
3546:
3544:
3541:
3539:
3536:
3534:
3531:
3530:
3529:
3526:
3525:
3523:
3521:
3517:
3511:
3508:
3504:
3501:
3499:
3496:
3495:
3494:
3493:
3489:
3488:
3485:
3482:
3480:
3477:
3475:
3471:
3468:
3464:
3461:
3459:
3456:
3454:
3451:
3450:
3449:
3446:
3445:
3443:
3441:
3435:
3431:
3425:
3422:
3420:
3417:
3415:
3412:
3410:
3407:
3405:
3402:
3400:
3399:Cholecystitis
3397:
3396:
3394:
3392:
3388:
3380:
3377:
3375:
3372:
3371:
3370:
3367:
3365:
3362:
3360:
3357:
3353:
3350:
3348:
3345:
3344:
3343:
3342:Liver abscess
3340:
3336:
3333:
3331:
3328:
3327:
3326:
3325:Liver failure
3323:
3321:
3318:
3314:
3311:
3309:
3306:
3304:
3301:
3299:
3296:
3295:
3294:
3293:
3289:
3285:
3282:
3281:
3280:
3277:
3273:
3270:
3269:
3268:
3265:
3261:
3258:
3256:
3253:
3251:
3248:
3247:
3246:
3243:
3242:
3240:
3238:
3234:
3231:
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3005:
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2982:Enterocolitis
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2684:Gastroparesis
2682:
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2677:
2675:
2672:
2668:
2665:
2664:
2663:
2660:
2656:
2653:
2651:
2650:Cushing ulcer
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2595:Megaesophagus
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2020:
2016:
2012:
2008:
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1993:
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1985:
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1800:on 2007-09-28
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1767:on 2007-10-24
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1734:on 2007-10-06
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477:
475:
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469:
465:
460:
458:
457:Trendelenburg
453:
450:
446:
442:
437:
434:
433:Band ligation
430:
427:
426:cauterization
423:
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417:
413:
410:
405:
402:
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384:
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298:
297:hiatal hernia
292:
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89:
85:
82:
78:
75:
71:
68: –
67:
63:
62:Find sources:
56:
52:
46:
45:
40:This article
38:
34:
29:
28:
19:
3672:
3651:
3528:Pancreatitis
3490:
3440:biliary tree
3313:Nutmeg liver
3290:
3216:Hematochezia
3167:Pruritus ani
3152:Anal abscess
3147:Anal fistula
3143:Anal fissure
3056:Constipation
3010:
2881:Appendicitis
2689:Gastroptosis
2679:Achlorhydria
2528:
2518:
2507:Eosinophilic
2421:
2410:
2399:
2375:
2364:
2349:
2334:
2295:
2285:
2268:
2258:
2221:
2217:
2207:
2182:
2178:
2132:
2128:
2082:
2078:
2047:(1): 75–83.
2044:
2040:
2002:
1998:
1992:
1957:
1953:
1943:
1911:(2): 49–56.
1908:
1904:
1894:
1867:
1863:
1835:. Retrieved
1823:
1813:
1802:. Retrieved
1798:the original
1789:
1780:
1769:. Retrieved
1765:the original
1756:
1747:
1736:. Retrieved
1732:the original
1718:
1708:, retrieved
1696:
1686:
1661:
1657:
1651:
1624:
1620:
1610:
1585:
1581:
1545:
1541:
1535:
1508:
1504:
1494:
1472:(1): 65–67.
1469:
1465:
1459:
1446:
1442:
1431:. Retrieved
1419:
1381:
1377:
1370:
1359:. Retrieved
1347:
1337:
1320:
1316:
1293:(2): 75–77.
1290:
1286:
1280:
1245:
1241:
1203:
1199:
1193:
1168:
1164:
1138:
1128:
1111:
1101:
1084:
1080:
1074:
1063:. Retrieved
1051:
991:
987:
977:
950:
918:(5): AB132.
915:
911:
905:
862:
858:
848:
823:
819:
793:
789:
783:
748:
744:
704:
700:
694:
669:
665:
641:. Retrieved
629:
565:
561:
511:Medications
461:
454:
445:embolization
438:
432:
431:
418:
415:
414:
403:
400:
399:
394:Hemoclipping
393:
392:
388:
372:
357:
348:
344:
333:
318:
293:
274:
248:
237:
228:
216:
212:
185:
184:
128:
113:
107:October 2015
104:
94:
87:
80:
73:
61:
49:Please help
44:verification
41:
3708:Peritonitis
3470:Cholestasis
3448:Cholangitis
3391:Gallbladder
3279:Fatty liver
3199:Hematemesis
3181:GI bleeding
2987:Necrotizing
2916:Lymphocytic
2911:Collagenous
2906:Microscopic
2843:Steatorrhea
2744:Enteropathy
2590:Inlet patch
2512:Herpetiform
2497:Esophagitis
2401:MedlinePlus
2005:: 267–277.
1087:(1): 7–12.
994:: 5454791.
530:Antiemetics
496:Hematemesis
472:antiemetics
449:gastrostomy
441:angiography
421:epinephrine
240:hematemesis
203:hematemesis
142:Other names
3744:Categories
3700:Peritoneal
3678:Incisional
3599:Congenital
3543:Hereditary
3520:Pancreatic
3484:Haemobilia
3157:Hemorrhoid
3135:Anal canal
3073:Infectious
3061:Functional
2896:Ulcerative
2780:Duodenitis
2719:Gastrinoma
2423:Patient UK
2377:DiseasesDB
2296:StatPearls
2269:StatPearls
2085:(3): 175.
1837:2024-07-24
1824:StatPearls
1804:2007-10-07
1771:2007-10-07
1738:2007-10-07
1710:2024-08-01
1697:StatPearls
1433:2024-07-25
1420:StatPearls
1378:Hepatology
1361:2024-07-24
1348:StatPearls
1139:StatPearls
1112:StatPearls
1065:2024-07-25
1052:StatPearls
865:(5): 810.
643:2024-07-23
630:StatPearls
538:References
401:Heat probe
277:alcoholism
251:endoscopic
223:Soma Weiss
195:alcoholism
77:newspapers
3765:Syndromes
3688:Richter's
3645:Spigelian
3640:Obturator
3630:Umbilical
3463:Ascending
3434:Bile duct
3267:Cirrhosis
3245:Hepatitis
3228:Accessory
3098:Proctitis
2949:Megacolon
2923:Dysentery
2833:Whipple's
2785:Jejunitis
2775:Enteritis
2662:Dyspepsia
2623:Gastritis
2556:Achalasia
2489:Esophagus
2412:eMedicine
2107:195343875
2061:1534-309X
1886:2598-3180
1870:(2): 98.
1643:2221-6189
1453:eMedicine
879:0003-4932
416:Injection
385:Treatment
360:endoscopy
354:Diagnosis
329:cirrhosis
306:ibuprofen
165:Specialty
3760:Vomiting
3618:Indirect
3613:Inguinal
3347:Pyogenic
3292:Vascular
3068:Diarrhea
3046:Volvulus
3012:Vascular
2951: /
2940: /
2901:Ischemic
2868:Appendix
2758:Duodenum
2628:Atrophic
2502:Candidal
2417:ped/1359
2304:28722967
2277:28613559
2250:26034370
2199:22560400
2161:26998186
2135:(1): 7.
2099:15913474
1984:33162733
1935:32346211
1832:30335301
1705:30969693
1562:19772708
1486:10941865
1428:28846255
1398:12297841
1356:29939540
1329:32109037
1272:11851641
1185:28007004
1147:28613774
1120:32965849
1060:30285387
1020:28348579
840:13111391
775:25844336
638:30855778
478:See also
379:duodenum
283:such as
255:surgical
3659:Petit's
3635:Femoral
3538:Chronic
3352:Amoebic
3120:Anismus
2886:Colitis
2813:Coeliac
2790:Ileitis
2762:Jejunum
2615:Stomach
2519:Rupture
2371:D008309
2241:4445112
2152:4799841
2019:3555295
1975:7599350
1926:7186277
1678:7304810
1602:2230001
1527:8072208
1299:2287873
1263:1874281
1220:2744343
1093:2657497
1048:"Shock"
1011:5350415
897:5923104
888:1477108
766:4381135
721:6334289
686:4579296
574:9780715
362:of the
209:History
199:bulimia
91:scholar
3653:Lumbar
3623:Direct
3606:Hiatus
3586:Hernia
3438:Other
3204:Melena
3090:Rectum
2573:(GERD)
2406:000269
2302:
2275:
2248:
2238:
2197:
2159:
2149:
2105:
2097:
2059:
2017:
1982:
1972:
1933:
1923:
1884:
1830:
1703:
1676:
1641:
1600:
1560:
1525:
1484:
1426:
1396:
1354:
1327:
1297:
1270:
1260:
1218:
1183:
1145:
1118:
1091:
1058:
1018:
1008:
965:
895:
885:
877:
838:
773:
763:
719:
684:
636:
572:
302:NSAIDs
271:Causes
244:melena
172:
93:
86:
79:
72:
64:
3578:Other
3533:Acute
3284:MASLD
3237:Liver
3211:Lower
3194:Upper
3036:Ileus
2872:Colon
2766:Ileum
2581:(LPR)
2360:530.7
2345:K22.6
2103:S2CID
310:NSAID
98:JSTOR
84:books
2966:SCAD
2382:7803
2366:MeSH
2355:9-CM
2300:PMID
2273:PMID
2246:PMID
2195:PMID
2157:PMID
2095:PMID
2057:ISSN
2015:PMID
1980:PMID
1931:PMID
1882:ISSN
1828:PMID
1728:BUPA
1701:PMID
1674:PMID
1639:ISSN
1598:PMID
1558:PMID
1523:PMID
1482:PMID
1424:PMID
1394:PMID
1352:PMID
1325:PMID
1295:PMID
1268:PMID
1216:PMID
1181:PMID
1143:PMID
1116:PMID
1089:PMID
1056:PMID
1016:PMID
992:2017
963:ISBN
893:PMID
875:ISSN
836:PMID
771:PMID
717:PMID
682:PMID
634:PMID
570:PMID
323:and
289:GERD
265:SANs
221:and
70:news
3272:PBC
2999:IBD
2933:IBS
2351:ICD
2336:ICD
2236:PMC
2226:doi
2187:doi
2147:PMC
2137:doi
2087:doi
2049:doi
2007:doi
1970:PMC
1962:doi
1921:PMC
1913:doi
1872:doi
1666:doi
1662:142
1629:doi
1590:doi
1550:doi
1513:doi
1474:doi
1451:at
1386:doi
1321:101
1258:PMC
1250:doi
1208:doi
1173:doi
1006:PMC
996:doi
955:doi
920:doi
883:PMC
867:doi
863:164
828:doi
824:249
798:doi
761:PMC
753:doi
709:doi
674:doi
443:or
424:or
419:of
253:or
197:or
53:by
3746::
3436:/
3034::
3015::
2811::
2426::
2415::
2404::
2380::
2369::
2358::
2343::
2340:10
2294:,
2267:.
2244:.
2234:.
2222:21
2220:.
2216:.
2193:.
2183:23
2181:.
2169:^
2155:.
2145:.
2131:.
2127:.
2115:^
2101:.
2093:.
2081:.
2069:^
2055:.
2043:.
2039:.
2027:^
2013:.
2003:38
2001:.
1978:.
1968:.
1958:33
1956:.
1952:.
1929:.
1919:.
1909:43
1907:.
1903:.
1880:.
1866:.
1862:.
1846:^
1822:.
1792:.
1788:.
1759:.
1755:.
1726:.
1695:,
1672:.
1660:.
1637:.
1623:.
1619:.
1596:.
1586:12
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