Mallory-Weiss syndrome in perspective.

Nineteen patients with the Mallory-Weiss lesion diagnosed by panendoscopy are presented. This represents 10.5% of 180 acute upper-gastrointestinal bleeders. Only 36.8% of these 19 patients had a history of heavy ethanol intake and 26% had hiatus hernias. In addition to the Mallory-Weiss lesion, abnormalities in 63% were noted on endoscopy. None of the patients required surgery for control of the bleeding. Two patients were treated with selective arterial-vasopressin infusion. The importance of a high index of suspicion for this lesion in spite of the lack of a classical alcoholic or recurrent retching history and the value of intensive medical therapy, including early panendoscopy, is emphasized.