Exacerbation of ulcer as a cause of Mellory-Weiss syndrome. Case reports

Aim. To analyze the results of treatment of patients with Mellory-Weiss syndrome (MWS) and describe a number of MWS cases, caused by exacerbation of the ulcer. To detect the characteristic features of the course of disease and possible variants of unfavorable outcome.

Materials and methods. There were analyzed the results of treatment of 176 patients with MWS, who received hospital treatment from 2008 to 2018.  Fifteen MWS cases, caused by ulcer exacerbation, were described. Statistical analysis was conducted; features of disease course were revealed. A clinical case of unfavorable variant of the disease course is presented.

Results. The study included 176 patients. Mellory-Weiss syndrome, caused by  ulcer, was registered in 15 of them (main group). The patients of the main group had pain syndrome, lower systolic arterial pressure, lower hemoglobin and erythrocyte amount at admission to hospital. The paper presents the variant of extremely unfavorable course of disease, when relapse of bleeding occurred not from laceration of the mucous membrane, but from the ulcer.

Conclusions. According to our observations, ulcer is a relatively frequent cause of MWS development and takes the second place after alcohol etiology. Such patients have peculiar features of disease course, which require different approach to diagnosis and management.