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Zespół Mallory’ego-Weissa – przyczyny, objawy, leczenie

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Zespół Mallory’ego-Weissa to zlokalizowane w okolicy wpustu żołądka podłużne pęknięcie błony śluzowej przełyku. Jaka jest patogeneza tego schorzenia i jak przebiega jego terapia?

Przyczyny zespołu Mallory’ego-Weissa

Podłużne pęknięcie błony śluzowej przełyku, które występuje w przebiegu zespołu Mallory’ego-Weissa, jest spowodowane gwałtownymi, długotrwałymi i częstymi wymiotami. Wśród przyczyn ostrych wymiotów, które mogą doprowadzić do rozwoju zespołu Mallory’ego-Weissa, wymienia się infekcje układu trawiennego, przepuklinę rozworu przełykowego, kamicę żółciową, zapalenie pęcherzyka żółciowego i wątroby, niedrożność przewodu pokarmowego i bulimię. W grupie ryzyka tego schorzenia znajdują się również osoby nadużywające alkoholu, kobiety w ciąży (cierpiące na zespół niepowściągliwych wymiotów) oraz pacjenci z nowotworami leczonymi za pomocą chemioterapii.

Objawy zespołu Mallory’ego-Weissa

Typowym objawem zespołu Mallory’ego-Weissa są krwiste lub fusowate wymioty. Może także wystąpić smolisty stolec (w przebiegu tego schorzenia nie stwierdza się jednak obecności w stolcu krwi żywoczerwonej). Pacjent odczuwa ból nadbrzusza, któremu może towarzyszyć ból w klatce piersiowej zbliżony do bólu zawałowego.

Diagnostyka zespołu Mallory’ego-Weissa opiera się na badaniu endoskopowym okolicy połączenia przełyku i żołądka. Zespół Mallory’ego-Weissa należy różnicować z zespołem Boerhaavego, w przypadku którego pęknięcie obejmuje całą ścianę przełyku.

Zespół Mallory’ego-Weissa może wpłynąć na wystąpienie silnego krwotoku. Schorzenie to odpowiada za ok. 15 proc. przypadków krwawienia z górnego odcinka przewodu pokarmowego.

Leczenie zespołu Mallory’ego-Weissa

W większości przypadków spowodowane uszkodzeniem błony śluzowej krwawienie ustępuje samoistnie. Pęknięcie ulega zagojeniu w ciągu 48-72 godzin. W przypadkach o ostrzejszym przebiegu stosuje się leczenie endoskopowe (metodą iniekcyjną, termiczną lub mechaniczną). Dodatkowo stosuje się farmakoterapię (m.in. inhibitory pompy protonowej, leki przeciwkrwotoczne, przeciwwymiotne) oraz resuscytację płynową.

Źródła: https://chirurgia-onkologia.com.pl/, http://www.monz.pl/, https://portal.abczdrowie.pl/

Przeczytaj także: Pierwsza pomoc przy oparzeniach dróg oddechowych

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