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Gastroenterology


Answer 1
  1. Observation. Mallory-Weiss tears are often, but not always, seen in patients with severe retching or vomiting. More than 80% of such tears will stop bleeding and ultimately heal, and only 2% to 5% of patients will experience rebleeding. Endoscopic therapy or surgical oversewing of the tear might be useful if severe recurrent bleeding occurs. Transjugular intrahepatic portosystemic shunt (TIPS) placement would not be beneficial, because the tear is not a result of portal hypertension. The use of a Blakemore tube, commonly available in most emergency departments, is unnecessary in a patient who is not bleeding.

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