Characterization of the Syndrome of UGI Bleeding from a Mallory-Weiss Tear Associated with Transesophageal Echocardiography

Cappell, Mitchell S.; Dass, Kathleen; P, Manickam

doi:10.1007/s10620-014-3195-2

Cited by 10 publications

(5 citation statements)

References 30 publications

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“… 17 A review of 17 cases of TEE‐related injury resembling Mallory–Weiss syndrome revealed that 24% received endoscopic therapy, 24% had rebleeding or continued bleeding after EGD, 18% required surgery or angiography, and 24% died. 18 We found eight cases of UGIB due to TEE‐related injury (0.7% of total) in our study, six of which were successfully treated endoscopically. None experienced rebleeding, required surgery or angiography, or died.…”

Section: Discussion/conclusionmentioning

confidence: 57%

Findings and outcomes of emergent endoscopies after cardiovascular surgery

et al. 2022

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Aims: Studies detailing endoscopic findings and hemostatic interventions for upper gastrointestinal bleeding after cardiovascular surgery are scarce. We conducted this study to determine the frequency and findings of emergent esophagogastroduodenoscopy (EGD) after cardiovascular surgery and the effect of bleeding requiring hemostatic intervention on clinical outcomes. Methods and Results: We retrospectively reviewed records of emergent EGD examinations conducted within 30 days after cardiovascular surgery at a tertiary referral center in Japan from April 2011 to March 2020. Of 1625 patients undergoing cardiovascular surgery, 47 underwent emergent EGD. Sources of bleeding were identified in 30 cases, including transesophageal echocardiogram (TEE)-related injuries (8 patients), gastric ulcers (7 patients), and duodenal ulcers (7 patients). Patients who required endoscopic hemostatic intervention had more TEE-related injuries (43% vs 3%, P = 0.005), gastric ulcers (35% vs 6%, P = 0.018), or ulcers in the first part of the duodenum (29% vs 0%, P = 0.006) than those who did not. Intraoperative TEE did not increase the need for endoscopic intervention (71% vs 64%, P = 0.435). Intraoperative TEE and the need for endoscopic intervention did not affect length of stay or all-cause mortality. Only one death was associated with gastrointestinal bleeding. Conclusion: Despite the potential severity of bleeding after cardiovascular surgery, most cases can be managed endoscopically with no increase in hospital stay or mortality.

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Section: Discussion/conclusionmentioning

confidence: 57%

Findings and outcomes of emergent endoscopies after cardiovascular surgery

et al. 2022

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“…Mallory-Weiss tear was first described in 1929 by Mallory et al [ 14 ] and Weiss et al [ 15 ]. It is defined as longitudinal, nonperforating mucosal lacerations in the gastroesophageal junction resulting in upper gastrointestinal bleeding.…”

Section: Discussionmentioning

confidence: 99%

“…Anaphylactic shock after administering cis-atracurium during the induction of anesthesia was considered one of the most likely causes[ 18 ]. The exact etiology of gastrointestinal injury in this case was also unknown; however, the interaction of closed-chest cardiac massage and the application of TEE may be involved as a most possible mechanism of injury[ 14 ]. There may be several reasons.…”

Section: Discussionmentioning

confidence: 99%

Upper gastrointestinal bleeding from a Mallory-Weiss tear associated with transesophageal echocardiography during successful cardiopulmonary resuscitation: A case report

Tang¹,

Fang²,

Liu³

2022

WJCC

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BACKGROUND In recent years, it has been recognized that transesophageal echocardiography (TEE) is of great value in resuscitation of cardiac arrest. However, its safety has rarely been reported. CASE SUMMARY We present a 59-year-old male patient scheduled to undergo cardiac surgery for rheumatic heart disease. Upper gastrointestinal bleeding from a Mallory-Weiss tear appeared following cardiopulmonary resuscitation, TEE, and percutaneous cardiopulmonary bypass resuscitation when he suffered from aesthesia-related cardiac arrest. Gastrointestinal injury was diagnosed promptly and treated effectively. However, the exact etiology of gastrointestinal injury was unclear; the interaction of closed-chest cardiac massage and the application of TEE may be involved as a most possible mechanism of injury. CONCLUSION Serious complications should be considered when TEE is used in patients with special pathophysiological conditions.

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“…[5] Mallory-Weiss tears with transesophageal echocardiography (MWa) may represent a different clinical condition from Mallory-Weiss tears without TEE (MWu). Cappell et al found that MWa patients had a considerably longer mean age, higher rates of concurrent anticoagulation, and higher mortality in a study of the literature that included 17 recognised instances of MWa and a reported series of 73 cases of MWu [1,3]. The link between Mallory-Weiss syndrome and a hiatal hernia (a protrusion of an organ, generally the upper section of the stomach into the chest cavity through the esophageal aperture of the diaphragm) is still up for question.…”

Section: Etiologymentioning

confidence: 99%

“…However, any event that causes a rapid rise in intragastric pressure or gastric protrusion into the oesophagus, including prior transesophageal echocardiography, can cause Mallory-Weiss syndrome. Mallory-Weiss rips are responsible for 1 to 15% of all occurrences of upper gastrointestinal haemorrhage [1,[2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Evaluation and Management of Mallory – Weiss Syndrome: A Review

Hussein

Alfaraj

Alshabwi

et al. 2021

JPRI

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Upper gastrointestinal bleeding is a symptom of Mallory-Weiss syndrome, which is caused by longitudinal mucosal lacerations (known as Mallory-Weiss tears) near the gastroesophageal junction or gastric cardia. Mallory-Weiss syndrome is rather prevalent, accounting for 3 to 10% of all upper gastrointestinal bleeding episodes. In mild circumstances, the disease may be asymptomatic. Hematemesis is the presenting symptom in 85 percent of patients. Blood is present in varying amounts, ranging from blood-streaked mucous to huge bright red haemorrhage. Other symptoms such as melena, dizziness, or syncope might occur as a result of heavy bleeding. The majority of the time, the bleeding is little and ends on its own. Endoscopy is frequently used to confirm the diagnosis of MWS. Although most patients may be treated with monitoring or conservative medicinal treatment, certain cases require endoscopic or surgical treatment. Despite the fact that MWS is a common cause of nonvariceal upper gastrointestinal bleeding (NVUGIB), little research has been done on it. This article discusses MWS Etiology, epidemiology, evaluation and management.

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Characterization of the Syndrome of UGI Bleeding from a Mallory-Weiss Tear Associated with Transesophageal Echocardiography

Cited by 10 publications

References 30 publications

Findings and outcomes of emergent endoscopies after cardiovascular surgery

Findings and outcomes of emergent endoscopies after cardiovascular surgery

Upper gastrointestinal bleeding from a Mallory-Weiss tear associated with transesophageal echocardiography during successful cardiopulmonary resuscitation: A case report

Evaluation and Management of Mallory – Weiss Syndrome: A Review

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