Characterised by a laceration often along the right border (or near) the gastro-oesophegeal junction

Patients present with non-variceal upper gastrointestinal bleeding.

Accounts for 3-5% of GI bleeding

The haemorrhage is usually self-limited, ceasing spontaneously in 80% to 90% of patients.

Pathophysiology:

The pathogenesis is not completely understood. However, most patients report an MWT after an event that provokes a sudden rise in the pressure gradient across the gastro-oesophageal junction, such as retching, vomiting, coughing, or straining.

Main Risk factors:

• Any condition predisposing to retching, vomitting, straining
• Chronic cough
• Hiatal hernia (found in 40-100% of pts with MWT)
• Alcohol use
• Iatrogenic (e.g. endoscopy)

PC

Main Sx - Haematemesis -

• Commonly presents with haematemesis after an episode of forceful or recurrent retching, vomiting, coughing, or straining
• Varies from streaks of blood mixed with gastric contents or ‘coffee ground’, to bright red