[A rare complication of ERCP: Mallory-Weiss syndrome].
OBJECTIVE
To describe the management and outcome after endoscopic treatment of hematemesis by Mallory-Weiss Syndrome (MWS) occurred after CPRE (suspected choledocolithiasis).


BACKGROUND
Although cough and retching is common during EGD or CPRE, MWS resulting from endoscopy seems to be uncommon (0.0001-0.04%) and always self-limiting.


METHODS
The patient was submitted to CPRE with the suspicion of choledocholithiasis. Eight hours after CPRE the patient presented with hematemesis and hypotension. With emergency EGD, the AA identified a small bleeding mucosal tear (visible vessel with spurting) just proximal to the esophagogastric junction. The patient was safely treated with endoscopic hemoclipping after the failure of sclerotherapy.


CONCLUSIONS
The usefulness of hemoclipping in MWS is emphasized: although always self-limiting, endoscopic hemostasis is mandatory in high risk patients. The hemoclips are effective and safe in hemostasis in the case of bleeding visible vessel (spurting or oozing), even with or after sclerotherapy. The hemoclips not obstacles the healing.
Sciumè
Carmelo
C
Università degli Studi di Palermo, Dipartimento di Chirurgia Generale, d'Urgenza e dei Trapianti d'Organo, Sezione di Chirurgia Generale ad Indirizzo Toracico. carmesci@hotmail.com
Geraci
Girolamo
G
Pisello
Franco
F
Li Volsi
Francesco
F
Facella
Tiziana
T
Frazzetta
Michele
M
Raimondo
Dario
D
Passariello
Paolo
P
Modica
Giuseppe
G
D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D005500:Follow-Up Studies; D006396:Hematemesis / Q000209:etiology* / Q000628:therapy*; D016558:Hemostasis, Endoscopic; D006801:Humans; D008297:Male; D008309:Mallory-Weiss Syndrome / Q000209:etiology*; D013997:Time Factors; D016896:Treatment Outcome