Mallory-Weiss Tear

A Mallory-Weiss tear is a longitudinal mucosal laceration at the gastro-oesophageal junction after a sudden rise in intra-abdominal pressure. Forceful retching, vomiting, coughing, or straining may produce the tear, and the typical clinical sequence is vomiting followed by fresh haematemesis. Bleeding is often self-limited, but disruption of a submucosal vessel can produce significant upper GI haemorrhage. The first nursing question is not simply whether a tear is present; it is whether the patient is maintaining airway protection and tissue perfusion. A stable patient can be risk-stratified with the Glasgow-Blatchford Score, while suspected bleeding requires upper endoscopy within 24 hours. Active bleeding is treated mechanically, whereas a non-bleeding tear does not automatically require endoscopic therapy. Severe chest pain or systemic toxicity should prompt consideration of Boerhaave syndrome, a full-thickness oesophageal rupture rather than a mucosal tear.