A Case Report: Life Saving Mallory-Weiss Syndrome

• Published in: Eurasian journal of emergency medicine Vol. 18; no. 4; pp. 223 - 225
• Main Authors: Doğan, Serkan, Can, Doğanay, Bildik, Büşra, Kalafat, Utku Murat, Erdur, Ahmet, Yazıcı, Ramiz, Dörter, Melis, Cander, Başar
• Format: Journal Article
• Language: English
• Published: Ankara Galenos Publishing House 01.12.2019
• Subjects: Acidosis; Case reports; Emergency medical care; Hemodialysis; Vomiting
• ISSN: 2149-5807; 2149-6048
• DOI: 10.4274/eajem.galenos.2019.68815

Mallory-Weiss syndrome is characterized by a mucosa rupture on the gastroesophageal junction and usually associated with intense retching, cough, straining, or vomiting. Methanol intoxication is a cause for severe mortality and morbidity. We aimed to emphasize the lifesaving importance of history taking, rapid diagnosis, and treatment for Mallory-Weiss syndrome secondary to methanol intoxication in the present case. A 54-year old male patient admitted to the emergency service by ambulance with the complaint of bloody vomiting. The patient’s overall condition was moderate, and he was confused. He was taken into the resuscitation room. The patient was admitted to urgent endoscopy because of active bleeding. It was detected that he had drunk the alcohol that he made at home and presented bloody vomiting when he woke up in the morning. The patient was diagnosed with methanol intoxication and upper gastrointestinal system (GIS) bleeding. After intravenous infusion of 10 mL/kg loading dose of 10% ethanol, infusion continued by 1.5 mL/kg/hour. Urgent hemodialysis was implemented after infusion of 1 mEq/kg NaHCO3 into the patient presenting severe acidosis. The patient was admitted for further tests and treatment after hemodialysis; he was discharged by cure after nine days. Mallory-Weiss syndrome may develop in GIS bleeding cases triggered by vomiting and have mortal causes. The complaints that start with severe vomiting may be caused by fatal conditions such as methanol intoxication like in the present case. Therefore, a detailed patient history, as well as rapid diagnosis and treatment by emergency clinicians, have vital importance.