Diagnosis and management of Mallory Weiss syndrome

Mallory-Weiss Syndrome (MWS) is a gastrointestinal condition characterized by longitudinal mucosal lacerations at the gastroesophageal junction, typically following forceful vomiting or sudden increases in intra-abdominal pressure. Although often self-limiting, MWS can lead to upper gastrointestinal bleeding with symptoms such as hematemesis, melena, epigastric pain, and hemodynamic instability. The diagnosis is established through detailed anamnesis, physical examination, and endoscopic confirmation, which remains the gold standard for detecting mucosal tears and assessing bleeding severity. Risk factors include chronic alcohol consumption, retching, hiatal hernia, and gastroesophageal reflux, though some patients may present without identifiable causes. Management primarily involves hemodynamic stabilization, pharmacologic therapy with proton pump inhibitors, and, when needed, endoscopic interventions such as epinephrine injection, thermal coagulation, hemoclips, or band ligation. In rare cases, angiographic or surgical approaches may be indicated for persistent or massive bleeding. Understanding the anatomy and physiology of the esophagus is essential to recognize MWS and differentiate it from other causes of upper GI bleeding, including Boerhaave syndrome. This review highlights the importance of early diagnosis and tailored treatment strategies to reduce complications and improve outcomes in patients with Mallory-Weiss Syndrome.