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Anterior High-Resolution Optical Coherence Tomography in the Diagnosis and Therapeutic Monitoring of Ocular Surface Squamous Neoplasia
Published on: August 9, 2024
[Mallory-Weiss lesions]
1Arhus Universitetshospital, Arhus Sygehus, Kirurgisk Gastroenterologisk Afdeling L, Denmark. jeppelange@hotmail.com
Introduction:
Mallory-Weiss syndrome (MW) has been know since 1929. Only few studies exist which focus on the prognosis of the lesion. No Danish MW data are available. The purpose of the study was to describe the demographics of patients admitted with an MW to a Danish surgical unit during a 5-year period and to investigate the prognosis of these patients.
Material And Methods:
Data from the patient records of 49 patients with endoscopically verified MW admitted through a five-year period were analysed. At follow-up, 35 patients were alive and contacted. A total of 29 responded. The mean time to follow-up from admittance was 42.7 months (range: 10.1-77.1).
Results:
Haemostasis was achieved in all 49 patients. Sixteen received active therapy during the endoscopic procedure. Haemoglobin at admittance was lower (p = 0.008), the presence of bleeding stigmata higher (p < 0.0001) and the number of patients receiving blood transfusion higher (p = 0.01) among those receiving active therapy than among the group receiving no therapy at the time of their endoscopy. At follow-up, 50% of those receiving active therapy were dead (eight of 16) compared with 18% (six of 33) in the no-therapy group (p = 0.02). In the follow-up period, 10% of the patients admitted with an MW were re-admitted for a new gastrointestinal bleeding.
Conclusion:
Our data suggests that an attitude change is needed toward MW with bleeding stigmata. The course of the disease may not be as benign as generally believed. Further prospective studies designed to resolve this matter are needed.
Insights
Mallory-Weiss syndrome (MW) prognosis may be less benign than assumed. Active endoscopic therapy for bleeding stigmata in MW patients correlated with higher mortality and re-admission rates.
Area of Science:
- Gastroenterology
- Surgical Endoscopy
- Clinical Prognosis
Background:
- Mallory-Weiss syndrome (MW) is a known condition since 1929.
- Limited studies focus on MW lesion prognosis.
- No prior Danish data on MW prognosis existed.
Purpose of the Study:
- To describe patient demographics admitted with MW to a Danish surgical unit over five years.
- To investigate the prognosis of these MW patients.
Main Methods:
- Retrospective analysis of 49 patients with endoscopically verified MW.
- Follow-up data collected from surviving patients.
- Mean follow-up duration of 42.7 months.
Main Results:
- Hemostasis achieved in all 49 patients.
- Active endoscopic therapy group showed lower hemoglobin, higher bleeding stigmata, and more transfusions.
- Active therapy group had significantly higher mortality (50% vs. 18%) and 10% re-admission for GI bleeding.
Conclusions:
- A shift in attitude towards MW with bleeding stigmata is suggested.
- The disease course may be more severe than commonly believed.
- Further prospective studies are necessary to confirm these findings.
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