The Mallory-Weiss syndrome. A prospective study in 130 patients.

The clinical features of the Mallory-Weiss syndrome were prospectively documented in 130 of 1 667 patients submitted to endoscopy for gastro-intestinal haemorrhage, an incidence of 7,8%. The important clinical features found in these patients were: alcohol abuse (21%); retching or vomiting (38%); salicylate ingestion (36%); dyspepsia (39%). The correct clinical diagnosis was therefore often difficult to make. Additional lesions were found in 40% of patients at endoscopy. Blood loss was relatively small, and surgery was not required in any patient. The 2 deaths that occurred were not attributable to haemorrhage. A high index of suspicion and early endoscopy are required to establish the diagnosis.