A Mallory-Weiss tear is characterized by acute and sometimes massive UGI hemorrhage. It accounts for up to 10%. of UGI bleeds. It is due to arterial bleeding following repeated vomiting (which causes mucosal tears at the GE junction). The cause is the same as that for spontaneous rupture of the esophagus (i.e., an increase in intra-abdominal pressure against a closed glottis). Causes other than vomiting such as paroxysmal coughing or retching, may sometimes lead to this condition. Upper endoscopy confirms the diagnosis. Surgery may occasionally be necessary to stop the bleeding.