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Risk Factors for an Iatrogenic Mallory-Weiss Tear Requiring Bleeding Control during a Screening Upper Endoscopy

Shin Na1, Ji Yong Ahn1, Kee Wook Jung1

  • 1Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, Republic of Korea.

Gastroenterology Research and Practice
|March 29, 2017
PubMed

Insights

Severe iatrogenic Mallory-Weiss tears (MWTs) during endoscopy are linked to older age, prior gastrectomy, and less experienced endoscopists. Hemoclips are effective for bleeding control in these cases.

Area of Science:

  • Gastroenterology
  • Endoscopy
  • Surgical Complications

Background:

  • Iatrogenic Mallory-Weiss tears (MWTs) can cause severe bleeding requiring endoscopic intervention.
  • Identifying risk factors is crucial for preventing and managing these complications.

Purpose of the Study:

  • To evaluate risk factors associated with severe iatrogenic MWTs.
  • To assess endoscopic methods for bleeding control in these cases.

Main Methods:

  • Retrospective analysis of 426,085 screening upper endoscopies (2008-2012).
  • Identified patients with iatrogenic MWTs requiring endoscopic hemostasis.
  • Multivariate analysis of risk factors and treatment modalities.

Main Results:

  • Iatrogenic MWTs occurred in 0.13% of procedures (546 cases).
  • Severe bleeding requiring intervention occurred in 13.0% of MWT cases (71 patients).
  • Risk factors included older age, distal gastrectomy history, and endoscopist inexperience (<2,237.5 procedures). Hemoclips were used in 81.7% of interventions.

Conclusions:

  • Careful endoscopic procedures are recommended for elderly patients and those with a history of distal gastrectomy.
  • Particular caution is advised for less experienced endoscopists to minimize severe iatrogenic MWTs.

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