• Pathophysiology
  1. Severe Retching results in tear in esophageal mucosa
  2. Lesion occurs near esophagogastric junction
  • Epidemiology
  1. Incidence: 7.3 per 100,000
  • Symptoms
  1. Hematemesis follows episode of Retching or Vomiting
  • Signs
  1. Melena
  2. Shock
  • Differential Diagnosis
  1. Peptic Ulcer Disease
  2. Esophageal Perforation
  3. Esophagitis
  4. Esophageal Varices
  • Diagnosis
  1. Endoscopy (EGD)
    1. Mucosal tear directly visualized
  • Course
  1. Most spontaneously heal
  2. However, bleeding related mortality approaches that of Peptic Ulcer Bleeding (esp. age >65 and comorbidity)
  • Management
  1. Generally heals spontaneously within several days
  2. Endoscopy for cauterization if needed
  3. Surgery rarely required
  • References
  1. Ljubicic (2014) Scand J Gastroenterol 49(4): 458-64 +PMID:24495010