Mallory-Weiss Tear + Endoscopy + EGD

What is a Mallory-Weiss tear?

A crack-like laceration in the esophagus or stomach - usually in the gastroesophageal junction

What are the causes of a mallory-weiss tear?

• Long-term retching (bulimia)

• heavy alcohol use

• Esophagitis

• Vomiting disorders

• GERD

• portal HTN

• hiatal hernia

What are the complications of mallory-weiss tears?

• Anemia, SOB

• Fatigue, weakness

• Dry mouth

• Nausea

• Heart palpitations

• clammy skin

What conditions are associated with mallory-weiss tear?

• Bulimia

• Alcohol abuse

• GERD

• Hyperemesis gravidarum

• Hiatal hernias

• Seizures

What is endoscopy?

A diagnostic study that uses a camera to visualize the GI tract?

• can use a catheter or a capsule that the patient swallows

What is the purpose of endoscopy?

• gold standard for locating source of bleed

• determines risk of rebleeding

• can provide endoscopic therapy if necessary

• can obtain specimen and monitor healing progress

What are the complications of endoscopy?

• perforation

• infection

• sedation reactions

  • respiratory depression

• bleeding

• sore throat

• difficulty swallowing

What does EGD stand for?

Esophago-gastro-duodenoscopy

What does an EGD visualize?

• esophagus

• gastric (stomach)

• Duodenum (first section of the small intestine)

What are the complications of EGD?

• perforation

• hemorrhage

• duodenal hematoma

• infection

• gastric outlet obstruction

How does perforation present?

• sudden + severe abdominal pain

  • may radiate to back and shoulders

  • is not relieved with food or antacids

• abdominal distention or rigidity

• absent bowel tones

• n/v

• shallow respirations, weak pulse

How is perforation treated?

• stop spillage

• restore blood volume with fluids + blood

• Broad-spectrum antibiotics

• large perforations may need surgery + suctioning

How does gastric outlet obstruction present?

• discomfort/pain that is worse at the end of the day

• belching and vomiting may provide relief?

What is a gastric outlet obstruction? How is it treated?

• Obstruction in distal stomach and duodenum d/t edema, inflammation, pylorospasm, and scar tissue.

• Use a NGT to decompress

Wha are the nursing care post-procedure

• educate pt about reporting gastric distress

• keep pt NPO, administer IV fluids

• Monitor vs, monitor labs, monitor airway

• Monitor for s/s of shock

• Check gastric content for pH, blood, or bile

• Assess for complications and bleeding