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      Síndrome de Mallory-Weiss. Reporte de caso y breve revisión de la literatura Translated title: Mallory-Weiss syndrome. Case report and brief review of the literature

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          Abstract

          Resumen Introducción El síndrome de Mallory-Weiss se caracteriza por el desgarro longitudinal de la mucosa de la unión gastroesofágica. En el presente trabajo hemos realizado una breve revisión de la literatura de utilidad para el estudiante de medicina y la hemos acompañado de un caso clínico para ilustrar el contenido aquí desarrollado. Caso Paciente del sexo masculino, de 40 años de edad, que acudió al servicio de urgencias de nuestra institución por presentar hematemesis, melena, datos de hipovolemia, e hipo de 2 días de evolución. Como antecedentes de importancia refirió consumo de alcohol a razón de 15 copas cada tercer día. Durante la endoscopía diagnóstica se identificó en la unión esofagogástrica, un coágulo adherente a la mucosa de 5 mm, con lo que se diagnosticó un desgarro de Mallory-Weiss. El tratamiento se realizó mediante endoscopía. Se optó por una inyección local de adrenalina con colocación posterior de liga. El paciente fue dado de alta sin complicaciones. Conclusión Los estudios realizados sobre el síndrome de Mallory-Weiss han permitido actualizar la información que se tiene al respecto. El avance tecnológico y científico ha incrementado las tasas de éxito del manejo de esta identidad.

          Translated abstract

          Abstract Introduction Mallory-Weiss syndrome is characterized by the longitudinal tear of the mucosa of the gastroesophageal junction. In the present work we have made a brief review of the literature useful for the medical student and we have accompanied a clinical case to illustrate the content developed here. Case A 40-year-old male attended the emergency department of our institution due to hematemesis, melena, hypovolemia, and 2-day history of hiccups. The patient referred alcohol consumption at a rate of 15 drinks every third day. During diagnostic endoscopy, a mucosal adherent clot of 5 mm was identified in the gastric esophageal junction, and a Mallory-Weiss tear was diagnosed. The treatment was performed by endoscopy. We opted for a local injection of Adrenaline with subsequent endoscopic ligation. The patient was discharged without complications. Conclusion The studies carried out on the Mallory-Weiss Syndrome have made it possible to update the information available. The technological and scientific advance has increased the success rates of the management of this identity.

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          Most cited references14

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          Endoscopic hemoclip placement and epinephrine injection for Mallory-Weiss syndrome with active bleeding.

          Mallory-Weiss syndrome with active bleeding requires effective hemostasis. This is an investigation of the respective efficacy and safety of endoscopic hemoclip placement and endoscopic epinephrine injection in Mallory-Weiss syndrome.
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            A prospective, randomized trial of endoscopic band ligation vs. epinephrine injection for actively bleeding Mallory-Weiss syndrome.

            Effective hemostatic treatment is mandatory for patients with actively bleeding Mallory-Weiss syndrome. This study evaluated the respective efficacy and the safety of endoscopic band ligation and endoscopic epinephrine injection in Mallory-Weiss syndrome.
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              Clinical significance of Mallory-Weiss tears.

              To assess course and outcome of patients with endoscopically diagnosed Mallory-Weiss tear bleeding. Thirty-four subjects seen during a 5-yr period formed the study group. Available follow-up after index bleed was 27.5 months +/- 2.7 SEM. There was no antecedent explanation for the tear, such as nausea, retching, abdominal pain, or vomiting in 12/28 (42.9%). Hematemesis on first emesis was noted in 13/26 (50%). Mean transfusion requirements were 2.6 +/- 1.0 (SEM) units of packed cells (range, 0-28), and 9/34 (26.5%) received four or more units. Two had therapeutic endoscopy and three required surgery to control bleeding. Thirty-day mortality noted four deaths, all multiorgan system failure related to the bleed. Patients who died had other endoscopic abnormalities, such as ulcers or varices, and all had an alcohol history. Two patients of 20 contacted had recurrent bleeding. One had another tear. The other had intermittent recurrent bleeding and refused care. Mallory-Weiss tear bleeding may be significant and recurrent. It may cause death or require transfusion, therapeutic endoscopy, and surgery.
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                Author and article information

                Journal
                facmed
                Revista de la Facultad de Medicina (México)
                Rev. Fac. Med. (Méx.)
                Universidad Nacional Autónoma de México, Facultad de Medicina (Ciudad de México, Ciudad de México, Mexico )
                0026-1742
                2448-4865
                October 2019
                : 62
                : 5
                : 16-20
                Affiliations
                [1] CDMX orgnameHospital General Dr. Manuel Gea. González orgdiv1División de Endoscopía Gastrointestinal Mexico
                [4] CDMX orgnameUniversidad Nacional Autónoma de México Mexico
                [2] CDMX orgnameHospital General Dr. Manuel Gea. González orgdiv1Subdirección de Cirugía General Mexico
                [3] CDMX orgnameUniversidad Nacional Autónoma de México Mexico
                [5] CDMX orgnameHospital General Dr. Manuel Gea. González orgdiv1División de Cirugía General Mexico
                Article
                S0026-17422019000500016 S0026-1742(19)06200500016
                10.22201/fm.24484865e.2019.62.5.04
                b70002f7-5559-41c1-b526-859da55a7f62

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 30 May 2019
                : 07 December 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 14, Pages: 5
                Product

                SciELO Mexico

                Categories
                Casos clínicos

                Mallory Weiss Syndrome,lacerations of the gastroesophageal union mucosa,laceraciones de la mucosa de la unión gastroesofágica,Síndrome de Mallory Weiss

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