Or gastro-esophageal laceration syndrome.
Refers to to bleeding from tears in the mucosa at the junction of the stomach and esophagus, usually as a result of vomiting or coughing.
Often associated with alcoholism and eating disorders.
Hiatal hernia is a predisposing condition, and abuse of non steroidal anti-inflammatory drugs may be related.
Hyperemesis gravidarum may be associated.
The tear involves mucosa and submucosa.
When additionally the muscular layer is involved it is ref2242ed to as the Boerhaave syndrome.
The mean age is more than 60 years.
80% of patients are men.
Commonly presents as an episode of hematemesis after violent retching or vomiting.
Patients may also present with melena and an absence of a history of vomiting.
Bleeding usually stops spontaneously within 24-48 hours.
The persistence in bleeding, however, may require endoscopic or surgical treatment.
Endoscopic cauterization or injection of epinephrine may be performed in the presence of continued bleeding.
Rarely fatal.
Definitive diagnosis requires endoscopy.
Treatment is usually supportive care.
Rarely embolization of the arterial supply may be required to stop the bleeding.
Ligation of the bleeding vessel may be required with persistent bleeding.