title: Risk Factors for an Iatrogenic Mallory-Weiss Tear Requiring Bleeding Control during a Screening Upper Endoscopy.
abstract: Background and Aim.In some cases of iatrogenic Mallory-Weiss tears (MWTs), hemostasis is needed due to severe mucosal tearing with bleeding. Therefore, we aimed to evaluate the risk factors for severe iatrogenic MWTs and the methods of endoscopic bleeding control.Materials and Methods.Between January 2008 and December 2012, 426,085 cases of screening upper endoscopy were performed at the Asan Medical Center. We retrospectively analyzed the risk factors for severe iatrogenic MWTs requiring an endoscopic procedure and the treatment modalities of bleeding control.Results.Iatrogenic MWTs occurred in 546 cases (0.13%) of screening upper endoscopy in 539 patients. Bleeding control due to severe bleeding was applied in 71 cases (13.0%), and rebleeding after initial bleeding control occurred in 1 case. Multivariate analysis showed that old age, a history of distal gastrectomy, and a less-experienced endoscopist (fewer than 2,237.5 endoscopic procedures at the time of the MWT) were associated with severe iatrogenic MWTs requiring an endoscopic procedure. Among 71 cases requiring bleeding control, a hemoclip was used in 81.7% (58 cases).Conclusions.Screening endoscopy procedures should be carefully performed when patients are in their old age and have a history of distal gastrectomy, particularly if the endoscopist is less experienced.
authors.affiliation: Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, Republic of Korea.
authors.forename: Shin
authors.initials: S
authors.lastname: Na
authors.affiliation: Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, Republic of Korea.
authors.forename: Ji Yong
authors.identifier: 0000-0002-0030-3744
authors.initials: JY
authors.lastname: Ahn
authors.affiliation: Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, Republic of Korea.
authors.forename: Kee Wook
authors.identifier: 0000-0002-3771-3691
authors.initials: KW
authors.lastname: Jung
authors.affiliation: Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, Republic of Korea.
authors.forename: Jeong Hoon
authors.identifier: 0000-0002-0778-7585
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, Republic of Korea.
authors.forename: Do Hoon
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, Republic of Korea.
authors.forename: Kee Don
authors.initials: KD
authors.lastname: Choi
authors.affiliation: Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, Republic of Korea.
authors.forename: Ho June
authors.initials: HJ
authors.lastname: Song
authors.affiliation: Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, Republic of Korea.
authors.forename: Gin Hyug
authors.initials: GH
authors.lastname: Lee
authors.affiliation: Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Seoul, Republic of Korea.
authors.forename: Hwoon-Yong
authors.initials: HY
authors.lastname: Jung
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
authors.forename: Seungbong
authors.initials: S
authors.lastname: Han