A 26-year-old women in the first trimester of pregnancy has been admitted with retching and repeated vomiting with large hematemesis. Her pulse rate is 126/minute and blood pressure is 80 mm Hg systolic. The most likely diagnosis is:
Correct Answer: Mallory-Weiss syndrome
Description: Upper gastrointestinal bleeding:
“Occasionally, persistent vomiting may be accompanied by worrisome upper gastrointestinal bleeding. The obvious concern is that there is a bleeding peptic ulceration, however, most of these women have minute linear mucosal tears near the gastroesophageal junction. Women with these co called Mallory-Weiss tears usually respond promptly to conservative measures.”
Ref. Williams 23/e, p 1053
With persistent retching the less common but more serious oesophageal rupture – ‘Boerhaave syndrome' may develop.
Category:
Gynaecology & Obstetrics
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