esophageal varices vs mallory weiss tear for alcoholics..

[MissMedicine]

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both of these are common causes of hematemesis/possibly leading to death for alcoholics, right? How can you tell from a vignette which occured?

 

[DrQuinn]

look for clues:

MW tear: severe retching with hematemesis with last vomitus

Esophageal varices: patietn with ESLD/cirrhosis, large amounts of hematemesis, stigmata of ESLD, hypotensive, etc.

Q, DO

 

[imtiaz]

if they are just suddenly passed out without any prior history of retching then it's more likely to be ruptured esophageal varices, if they give you a history of retching, or they tell you that the patient has aspirated vomitus or has pulmonary symptoms consistent with aspiration then it's more likely to be mallory weiss. hope this helps!

 

[MissMedicine]

thanks quinn. so are varices more serious? which one is painless? varices bleeding?

 

[barone ROCKS]

varices are far more dangerous, usually a death sentence.