Surgical Treatment of Mallory-Weiss Syndrome When Other Interventions Have Failed
Mallory-Weiss syndrome involves mucosal laceration at the gastric cardia, typically presenting with upper gastrointestinal bleeding. In a subset of patients, initial management strategies do not achieve durable haemostasis, and a surgical approach becomes necessary.
Clinical situation
This protocol addresses cases where endoscopic or angiographic interventions have not been sufficient to control bleeding. Surgery is reserved as the definitive last resort when less invasive options have been exhausted.
Approach — partial overview
Management involves direct surgical repair of the laceration at the gastric cardia. The specific technique — whether open or minimally invasive — and the full procedural algorithm are detailed in the structured protocol.
References
DOI: 10.30574/gscarr.2025.23.3.0177
- Surgery is rarely required and is considered a last resort following failed endoscopic or angiographic interventions.
- If no duodenal or gastric lesions are found, a wide gastrostomy is performed via laparotomy.
- Mallory-Weiss lacerations at the gastric cardia are readily visible and can be repaired using running catgut sutures.
- Endoscopy-guided laparoscopic suturing of the tear has demonstrated excellent outcomes.
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