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Mallory-Weiss syndrome in children
L Bak-Romaniszyn1, E Małecka-Panas, E Czkwianianc
1Department of Pediatrics, Military Medical University, Institute of Polish Mothers' Memorial Hospital, Lódź.
Insights
Mallory-Weiss syndrome is rare in children, affecting 0.3% of those undergoing endoscopy. Diverse causes contribute to this condition, emphasizing its consideration in pediatric upper gastrointestinal bleeding.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Endoscopy
Background:
- Mallory-Weiss syndrome, characterized by esophageal or gastric mucosal tears, is typically associated with forceful vomiting or retching.
- Etiology and incidence in pediatric populations require further elucidation.
Purpose of the Study:
- To determine the incidence of Mallory-Weiss syndrome in children.
- To investigate the diverse etiologic factors associated with this syndrome in pediatric patients.
Main Methods:
- Retrospective analysis of 2720 children (5 months to 18 years) undergoing upper gastrointestinal endoscopy.
- Diagnosis of Mallory-Weiss syndrome based on endoscopic findings of mucosal tears or scars.
Main Results:
- Mallory-Weiss syndrome was diagnosed in 8 children (0.3%) with linear mucosal tears or scars observed.
- No active bleeding was noted; common accompanying conditions included gastritis, duodenitis, and Helicobacter pylori infection.
- Associated conditions varied, including duodenal ulcer, asthma, GERD, carbon monoxide poisoning, and early pregnancy.
Conclusions:
- Mallory-Weiss syndrome is an uncommon but significant cause of upper gastrointestinal bleeding in children.
- A wide spectrum of etiologic factors contributes to Mallory-Weiss syndrome in the pediatric population.
Abstract:
The aim of the study was to evaluate the incidence and the etiology of Mallory-Weiss syndrome in children. The study population comprised 2720 children aged 5 months to 18 years who had undergone upper gastrointestinal endoscopy. Mallory-Weiss syndrome was diagnosed in eight (0.3%) of the examined children. Endoscopic examination in five of them revealed linear mucosal tears, mostly above and in one case also below the gastroesophageal junction. In three children a linear scar in the lower portion of the esophagus was seen. No signs of active bleeding were revealed in any of the cases. In four children, Mallory-Weiss syndrome was accompanied by gastritis and duodenitis; two of these children had Helicobacter pylori infection. The concomitant diseases were H. pylori-positive duodenal ulcer (1), bronchial asthma and gastroesophageal reflux disease (1), carbon monoxide poisoning (1). In one case Mallory-Weiss syndrome was diagnosed in early pregnancy. Mallory-Weiss syndrome should be considered, along with others, as a cause of acute upper gastrointestinal bleeding in children. There is a great variety of etiologic factors in Mallory-Weiss syndrome in children.