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Mallory-Weiss Tear — RACP Adult Medicine MCQ

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EasyGastroenterology & HepatologyMallory-Weiss TearRACP Adult Medicine

A 65-year-old man with a history of chronic alcohol use is admitted with an upper GI bleed. Endoscopy shows a Mallory-Weiss tear at the gastro-oesophageal junction. Active bleeding is seen. What is the most appropriate endoscopic treatment?

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Correct answer: C — Injection of adrenaline plus thermal coagulation or hemoclipping

Mallory-Weiss tears (mucosal lacerations at the GEJ from forceful retching/vomiting) cause 5–10% of upper GI bleeds. While most (80–90%) stop spontaneously, active bleeding at endoscopy requires treatment. Injection of dilute adrenaline (1:10,000) combined with thermal coagulation (heater probe, gold probe) or hemoclip application is effective. Band ligation is used for variceal bleeding, not Mallory-Weiss tears.

Reference: eTG – 2025 – Gastrointestinal