Systemic vasopressin therapy for Mallory-Weiss bleeding

Over a period of one year, five of 101 patients admitted to our center because of upper gastrointestinal bleeding were found to have a Mallory-Weiss tear. This condition usually responds to conservative management. Torrential bleeding necessitating surgery is uncommon. Three of the patients, reported here, bled torrentially and were considered surgical candidates. Two received systemic vasopressin while being prepared for operation, with rapid, dramatic cessation of bleeding. Although this is a limited experience, we are impressed enough to believe that intravenous vasopressin should be given a trial in all hospitalized patients who continue to bleed from a tear in the region of the esophagogastric junction.