Upper gastrointestinal hemorrhage from a Mallory-Weiss tear associated with an occult Richter's hernia and small bowel obstruction: to see the forest as well as the trees in the emergency department.
Mallory-Weiss tears are a common cause of upper gastrointestinal bleeding and are often associated with vomiting from heavy alcohol ingestion. Other causes of severe emesis can induce a Mallory-Weiss tear, and it may be important to diagnose these conditions so that appropriate therapy can be instituted. We report an unusual condition presenting with a Mallory-Weiss tear, a small bowel obstruction resulting from an occult Richter's hernia, which was not suspected or diagnosed at initial presentation.
Department of Surgery, Medical College of Georgia, Augusta 30912.
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R
Scallion
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JP
Wei
D000328:Adult; D004630:Emergencies; D017809:Fatal Outcome; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006519:Hepatitis, Alcoholic / Q000150:complications; D006555:Hernia, Ventral / Q000150:complications*; D006801:Humans; D007415:Intestinal Obstruction / Q000150:complications* / Q000175:diagnosis*; D008297:Male; D008309:Mallory-Weiss Syndrome / Q000150:complications*; D009102:Multiple Organ Failure