Esophageal and Cardia Mucosal Tear Syndrome
Introduction
Introduction to esophageal and cardiac mucosal tear syndrome Mallory-Weiss Syndrome, also known as Mallory-Weiss Syndrome, refers to frequent violent vomiting or other conditions that suddenly increase due to intra-abdominal pressure (such as severe coughing, weight lifting, forced bowel movements, etc.). Symptoms that cause the above gastrointestinal bleeding due to tears in the lower esophagus and/or esophagogastric junctions or gastric mucosa tears. basic knowledge Sickness ratio: 0.0001% Susceptible people: no special people Mode of infection: non-infectious Complications: cirrhosis, ascites, bloating
Cause
Etiology of esophageal and cardiac mucosal tear syndrome
Abdominal pressure and sudden increase in intragastric pressure are the main causes, and iatrogenic retching and vomiting, pregnancy vomiting, acute gastroenteritis, general gastroscopy, uremia, severe cough, forced bowel movements, weight lifting, childbirth, etc. can cause The intra-abdominal pressure and intragastric pressure suddenly increased.
Prevention
Esophageal and gastric cardia mucosal tear syndrome prevention
There are no effective preventive measures for this disease. Early detection, early diagnosis and early treatment are the key to the prevention and treatment of this disease. Once the disease occurs, it should be actively treated to prevent the occurrence of complications. Symptomatic treatment should be given as soon as possible if vomiting and stubborn reversal occur.
Complication
Complications of esophageal and cardiac mucosal tear syndrome Complications cirrhosis ascites bloating
The presence of underlying disease in patients has a certain impact on the occurrence and prognosis of MWS, especially in patients with esophageal varices. Repeated, massive hemorrhage should occur, which should be clinically emphasized. It has cirrhosis, esophageal varices, improper eating or A large amount of ascites causes abdominal distension, frequent nausea, vomiting, and large amount of bleeding. It is dark red blood or blood, which is similar to variceal bleeding.
Symptom
Esophageal and gastric cardia mucosal tear syndrome symptoms common symptoms repeated hematemesis
Frequent vomiting, followed by clinical manifestations of hematemesis. Hematemesis refers to the patient's vomiting of blood, due to acute bleeding of the upper digestive tract (the esophagus, stomach, duodenum, jejunum, pancreas, biliary tract after gastrojejunostomy). However, it can also be seen that some systemic diseases must exclude bleeding and hemoptysis in the mouth, nose, throat, etc. before determining hematemesis.
Examine
Examination of esophageal and cardiac mucosal tear syndrome
1. X-ray gas sputum double angiography can be seen irregular filling defects, sometimes tincture is located in the ulcer shadow, sometimes you can see the tincture near the hemorrhage is located in the ulcer shadow, sometimes you can see the tincture filling near the hemorrhage Defect zone.
2. Fiber endoscopy: 24 to 48 hours after the onset of emergency endoscopy, visible at the junction of the esophagus and stomach, the distal esophageal mucosa longitudinal tear, mostly single, but also multiple, only light lesions only see A hemorrhagic fissure, the inflammation of the surrounding mucosa is not obvious, the lesion is severe, the crack often covers the clot, the edge may have fresh bleeding, and the surrounding mucosa is congestion and edema.
3. Selective celiac angiography can detect bleeding at a rate of 0.5ml per minute. It can be seen that the contrast agent overflows from the junction of the esophagus and the stomach, and flows along the upper or lower esophagus to show the contour of the esophageal mucosa. Patients with negative endoscopy.
Diagnosis
Diagnosis and diagnosis of esophageal and cardiac mucosal tear syndrome
Diagnose based on
1. There are incentives and obvious medical history leading to increased intra-abdominal pressure.
2. Frequent vomiting, followed by clinical manifestations of hematemesis.
3. X-ray gas angiography, selective celiac angiography and fiber endoscopy have diagnostic value.
Differential diagnosis
It needs to be differentiated from upper gastrointestinal hemorrhage caused by spontaneous esophageal rupture, peptic ulcer, erosive hemorrhagic gastritis, and esophageal varices.
