WordNet

to separate or be separated by force; "planks were in danger of being torn from the crossbars"
fill with tears or shed tears; "Her eyes were tearing"
the act of tearing; "he took the manuscript in both hands and gave it a mighty tear"
a drop of the clear salty saline solution secreted by the lacrimal glands; "his story brought tears to her eyes" (同)teardrop
separate or cause to separate abruptly; "The rope snapped"; "tear the paper" (同)rupture, snap, bust
move quickly and violently; "The car tore down the street"; "He came charging into my office" (同)shoot, shoot down, charge, buck
a tropical evergreen shrub or small tree extensively cultivated in e.g. China and Japan and India; source of tea leaves; "tea has fragrant white flowers" (同)Camellia_sinensis
a light midafternoon meal of tea and sandwiches or cakes; "an Englishman would interrupt a war to have his afternoon tea" (同)afternoon tea, teatime
dried leaves of the tea shrub; used to make tea; "the store shelves held many different kinds of tea"; "they threw the tea into Boston harbor" (同)tea leaf
a beverage made by steeping tea leaves in water; "iced tea is a cooling drink"
a reception or party at which tea is served; "we met at the Deans tea for newcomers"
any of several imperial dynasties of China ruling from 220 to 265 and from 386 to 556 (同)Wei dynasty

PrepTutorEJDIC

…‘を'『裂く』,破る,引き裂く / 〈穴など〉‘を'『破って作る』 / (…から)…‘を'『引きはがす』,もぎ取る,引き離す《+away(down, off, out, up)+名+from(out of, off)+名》 / 《受動態》で‥‘を'裂いて(破って)分ける《+名+apart》 / 裂ける,破れる / 《副詞[句]を伴って》激しく(大急ぎで)動く,突進する
涙
〈U〉『茶』,(特に)紅茶 / 〈U〉(乾燥した)茶の葉;茶の木 / 〈U〉茶に似た飲料,煎じ茶 / 〈C〉〈U〉『午後のお茶』 / 〈C〉〈U〉『お茶の会』(午後の軽食を出すパーティー)

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/09/01 18:36:04」(JST)

wiki en

Mallory–Weiss syndrome or gastro-esophageal laceration syndrome refers to bleeding from tears (a Mallory-Weiss tear) in the mucosa at the junction of the stomach and esophagus, usually caused by severe alcoholism, retching, coughing, or vomiting.

Causes

It is often associated with alcoholism^[1] and eating disorders and there is some evidence that presence of a hiatal hernia is a predisposing condition. Forceful vomiting causes tear of the mucosa at the junction.

NSAID abuse is also a rare association.^{[citation needed]} The tear involves mucosa and submucosa but not the muscular layer (contrast to Boerhaave syndrome which involves all the layers).^[2] The mean age is more than 60 and 80% are men.^{[citation needed]} Hyperemesis gravidarum, which is severe morning sickness associated with vomiting and retching in pregnancy, is also a known cause of Mallory-Weiss tear.^[3]

Presentation

Mallory–Weiss syndrome often presents as an episode of vomiting up blood (hematemesis) after violent retching or vomiting, but may also be noticed as old blood in the stool (melena), and a history of retching may be absent.

In most cases, the bleeding stops spontaneously after 24–48 hours, but endoscopic or surgical treatment is sometimes required and rarely the condition is fatal. There won't be any abdominal pain^{[citation needed]}.

Diagnosis

Definitive diagnosis is by endoscopy.

Treatment

Treatment is usually supportive as persistent bleeding is uncommon. However cauterization or injection of epinephrine^[4] to stop the bleeding may be undertaken during the index endoscopy procedure. Very rarely embolization of the arteries supplying the region may be required to stop the bleeding. If all other methods fail, high gastrostomy can be used to ligate the bleeding vessel. It is to be noted that the tube will not be able to stop bleeding as here the bleeding is arterial and the pressure in the balloon is not sufficient to overcome the arterial pressure.

History

The condition was first described in 1929 by G. Kenneth Mallory and Soma Weiss in 15 alcoholic patients.^[5]

References

^ Caroli A, Follador R, Gobbi V, Breda P, Ricci G (1989). "[Mallory-Weiss syndrome. Personal experience and review of the literature]". Minerva dietologica e gastroenterologica (in Italian) 35 (1): 7–12. PMID 2657497.
^ Boerhaave Syndrome at eMedicine
^ Parva M, Finnegan M, Keiter C, Mercogliano G, Perez CM (August 2009). "Mallory-Weiss tear diagnosed in the immediate postpartum period: a case report". J Obstet Gynaecol Can 31 (8): 740–3. PMID 19772708.
^ Gawrieh S, Shaker R (2005). "Treatment of actively bleeding Mallory-Weiss syndrome: epinephrine injection or band ligation?". Current gastroenterology reports 7 (3): 175. PMID 15913474.
^ Weiss S, Mallory GK (1932). "Lesions of the cardiac orifice of the stomach produced by vomiting". Journal of the American Medical Association 98: 1353–5. doi:10.1001/jama.1932.02730420011005.

UpToDate Contents

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1. マロリー・ワイス症候群 mallory weiss syndrome
2. 消化管におけるエンドクリップ療法：出血性病変および病変外での出血 endoclip therapy in the gastrointestinal tract bleeding lesions and beyond
3. Causes of upper gastrointestinal bleeding in adults
4. 小児における上部消化管出血に対するアプローチ approach to upper gastrointestinal bleeding in children
5. 成人における神経性大食症症および気晴らし食い症候群：内科的合併症およびそのマネージメント bulimia nervosa and binge eating disorder in adults medical complications and their management

English Journal

Arteriovenous malformation and gastrointestinal bleeding in patients with the HeartMate II left ventricular assist device.

Demirozu ZT, Radovancevic R, Hochman LF, Gregoric ID, Letsou GV, Kar B, Bogaev RC, Frazier OH.SourceDepartment of Cardiopulmonary Transplantation, Texas Heart Institute at St Luke's Episcopal Hospital, Houston, Texas 77225-0345, USA.
The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation.J Heart Lung Transplant.2011 Aug;30(8):849-53. Epub 2011 Apr 29.
BACKGROUND: In this study we investigated gastrointestinal (GI) bleeding and its relationship to arteriovenous malformations (AVMs) in patients with the continuous-flow HeartMate II (HMII) left ventricular assist device (LVAD).METHODS: The records of 172 patients who received HMII support between No
PMID 21530318

Single-balloon versus double-balloon endoscopy for achieving total enteroscopy: a randomized, controlled trial.

Takano N, Yamada A, Watabe H, Togo G, Yamaji Y, Yoshida H, Kawabe T, Omata M, Koike K.SourceDepartment of Gastroenterology and Endoscopy and Endoscopic Surgery, University of Tokyo, Tokyo, Japan.
Gastrointestinal endoscopy.Gastrointest Endosc.2011 Apr;73(4):734-9. Epub 2011 Jan 26.
BACKGROUND: Balloon endoscopy has been accepted as an effective tool for examining the small intestine. Two types of balloon endoscopy, single and double, are commercially available. The difference in performance between these 2 types of balloon endoscopy has not yet been elucidated.OBJECTIVE: To co
PMID 21272875

Japanese Journal

The spectrum of spontaneous and iatrogenic esophageal injury. Perforations, Mallory-Weiss tears, and hematomas

YOUNES Z
J Clin Gastroenterol 29, 306-317, 1999
NAID 30018803915

Hematemesis and Melena : Mallory-Weiss Syndrome

MIWA Masahiko,KIKUCHI Kazuhiro,SENOUE Issei,WATANABE Hiroyuki,NOMIYAMA Tetsu,SUZUKI Sohtaro,HARASAWA Shigeru,TANI Norio,MIWA Takeshi
Tokai journal of experimental and clinical medicine 5(3), 289-292, 1980-07
… The records of 29 patients with Mallory-Weiss tears diagnosed by endoscopy are reviewed. … Single tears were the largest in number and 68% of the lacerations were seen just distal to the esophago-cardial junction. …
NAID 110004690554

Related Pictures

Mallory Weiss tear | SMARTY PANCE Mallory-Weiss tear. Causes, symptoms, treatment Mallory-Weiss tear Mallory-Weiss Tear: Overview of Mallory-Weiss Syndrome, Risk Factors for Mallory-Weiss Mallory Weiss Syndrome The Gastrointestinalatlas - gastrointestinalatlas.com Mallory-Weiss Syndrome|Treatment|Prognosis|Causes|Symptoms Mallory-Weiss tear, endoscopic view - Stock Image - C016/6670 - Science Photo Library A case of Mallory-Weiss tears randomized to Hemoclip group. A Oozing | Download Mallory-Weiss Syndrome - www.medicoapps.org

★リンクテーブル★

リンク元	「マロリー・ワイス症候群」
関連記事	「tear」「tea」

「マロリー・ワイス症候群」

Mallory–Weiss syndrome
	Mallory-Weiss tear affecting the esophageal side of the gastroesophageal junction
Classification and external resources
Specialty	gastroenterology
ICD-10	K22.6
ICD-9-CM	530.7
DiseasesDB	7803
MedlinePlus	000269
eMedicine	ped/1359
Patient UK	Mallory–Weiss syndrome
MeSH	D008309

　　[★]

英: Mallory-Weiss syndrome
同: Mallory-Weiss症候群。Mallory-Weiss裂傷？ Mallory-Weiss tears？ Mallory-Weiss lesion Mallory-Weiss laceration

概念

定義：「嘔吐などにより腹腔内圧が急激に上昇して噴門部近傍に裂創が発生し、これを出血源として顕出血をきたしたもの」
頻回かつ激しいの嘔吐により粘膜裂傷を生じこれにより吐血する病態。
胸腔内圧の上昇により食道胃接合部付近に粘膜下層までの裂創を来たす。裂創は噴門部小弯部に好発する。
典型的には激しい嘔吐を繰り返し、2回目以降の嘔吐で多量の新鮮血を認めることが多い。
嘔吐を繰り返すどんな病態もMallory-Weiss症候群の引き金となり得る。

頻度

30-50歳代の男性に多く、全消化管出血例の約3-15%を占める。

原因

嘔吐(アルコール多飲、妊娠悪阻、乗り物酔い、脳腫瘍、髄膜炎、内視鏡検査時の嘔吐反射誘発)
咳嗽、くしゃみ、排便、分娩後　→　腹腔内圧および胃食道内圧の上昇

症状

Mallory-Weiss症候群自体で胸痛や腹痛を伴うことは少ない。

検査

上部消化管内視鏡：食道から胃噴門部小弯にかけて縦走する裂創を認める(主に接合部直下の胃側に生じるが、時に接合部をまたいで食道に及ぶことがある)。小弯に次いで後壁に多い。裂創は1-2 条が多く、深さは粘膜に限局することが多い。
胸部レントゲン：縦隔に気腫がないことを確認
胸部レントゲン：縦隔に気腫がないことを確認

分類

I群：胃限局型　→　最も多い
II群：食道、胃併存型
III群：食道限局型

診断

確定診断は胃カメラによる。

鑑別診断

IMD.843

特発性食道破裂(ブールハーフェ症候群)：腹圧の上昇で起こりうる。粘膜壁全層の裂創。食道下部の左側に好発。出血は少ない。胸背部や腹部の激痛、呼吸困難、ショックを来す。基本的に手術療法。
逆流性食道炎
食道静脈瘤破裂
出血性胃潰瘍
急性胃粘膜病変(AGML)

治療

保存的治療でほとんどが自然止血され、再出血することはあまりない。

絶食、点滴、安静、輸血、止血剤投与
止血困難であれば、クリッピング術を施行する。

臨床経過

数日間で白苔を生じ瘢痕化する

国試

097A031

参考

1.

http://vitaminex.exblog.jp/9065112

「tear」

　　[★]

n.

引き裂くこと。裂け目、割れ目。急ぐ/慌てること

vi.

裂ける、破れる。急ぐ、慌てる。

vt.

～を引き裂く/ちぎる。(裂け目などを)開ける、作る。(皮膚などに)切り傷/裂傷を作る。(無理に～を)引きはがす。(組織などを)分裂/分離させる。～を苦しめる/悲しませる

n.

涙、涙液。滴、水滴。悲しみ、悲嘆。

vi.

涙が出る

「tea」

　　[★]

n.

茶

関: Camellia sinensis

[1] Caroli A, Follador R, Gobbi V, Breda P, Ricci G (1989). "[Mallory-Weiss syndrome. Personal experience and review of the literature]". Minerva dietologica e gastroenterologica (in Italian) 35 (1): 7–12. PMID 2657497.

[Boerhaave-2] Boerhaave Syndrome at eMedicine

[3] Parva M, Finnegan M, Keiter C, Mercogliano G, Perez CM (August 2009). "Mallory-Weiss tear diagnosed in the immediate postpartum period: a case report". J Obstet Gynaecol Can 31 (8): 740–3. PMID 19772708.

[pmid15913474-4] Gawrieh S, Shaker R (2005). "Treatment of actively bleeding Mallory-Weiss syndrome: epinephrine injection or band ligation?". Current gastroenterology reports 7 (3): 175. PMID 15913474.

[5] Weiss S, Mallory GK (1932). "Lesions of the cardiac orifice of the stomach produced by vomiting". Journal of the American Medical Association 98: 1353–5. doi:10.1001/jama.1932.02730420011005.

匿名

検索

案内

案内

Mallory-Weiss tears