Mallory-Weiss syndrome in four hemodialysis patients: a case study.
Hemodialysis
Mallory-Weiss syndrome
Treatment
Journal
BMC nephrology
ISSN: 1471-2369
Titre abrégé: BMC Nephrol
Pays: England
ID NLM: 100967793
Informations de publication
Date de publication:
27 06 2023
27 06 2023
Historique:
received:
18
03
2022
accepted:
20
06
2023
medline:
28
6
2023
pubmed:
27
6
2023
entrez:
26
6
2023
Statut:
epublish
Résumé
Hemodialysis patients are prone to gastrointestinal bleeding, and Mallory-Weiss syndrome (MWS) is one of the causes. Mallory-Weiss syndrome is often induced by severe vomiting, manifests as upper gastrointestinal bleeding, and is self-limited with a good prognosis. However, mild vomiting in hemodialysis patients can lead to the occurrence of MWS, and the mild early symptoms are easy to misdiagnose, leading to the aggravation of the disease. In this paper, we report four hemodialysis patients with MWS. All patients displayed symptoms of upper gastrointestinal bleeding. The diagnosis of MWS was confirmed by gastroscopy. One patient had a history of severe vomiting; however, the other three reported histories of mild vomiting. Three patients received the conservative hemostasis treatment, and the gastrointestinal bleeding stopped. One patient underwent the gastroscopic and interventional hemostasis treatments. The conditions of three of the patients improved. Unfortunately, one of the patients died due to the cardia insufficiency. We think that the mild symptoms of MWS are easily covered up by other symptoms. This may lead to delays in diagnosis and treatment. For patients with severe symptoms, gastroscopic hemostasis is still the first choice, and interventional hemostasis can also be considered. For patients with mild symptoms, drug hemostasis is the first consideration.
Sections du résumé
BACKGROUND
Hemodialysis patients are prone to gastrointestinal bleeding, and Mallory-Weiss syndrome (MWS) is one of the causes. Mallory-Weiss syndrome is often induced by severe vomiting, manifests as upper gastrointestinal bleeding, and is self-limited with a good prognosis. However, mild vomiting in hemodialysis patients can lead to the occurrence of MWS, and the mild early symptoms are easy to misdiagnose, leading to the aggravation of the disease.
CASE PRESENTATION
In this paper, we report four hemodialysis patients with MWS. All patients displayed symptoms of upper gastrointestinal bleeding. The diagnosis of MWS was confirmed by gastroscopy. One patient had a history of severe vomiting; however, the other three reported histories of mild vomiting. Three patients received the conservative hemostasis treatment, and the gastrointestinal bleeding stopped. One patient underwent the gastroscopic and interventional hemostasis treatments. The conditions of three of the patients improved. Unfortunately, one of the patients died due to the cardia insufficiency.
CONCLUSIONS
We think that the mild symptoms of MWS are easily covered up by other symptoms. This may lead to delays in diagnosis and treatment. For patients with severe symptoms, gastroscopic hemostasis is still the first choice, and interventional hemostasis can also be considered. For patients with mild symptoms, drug hemostasis is the first consideration.
Identifiants
pubmed: 37365498
doi: 10.1186/s12882-023-03250-x
pii: 10.1186/s12882-023-03250-x
pmc: PMC10294486
doi:
Types de publication
Case Reports
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
188Informations de copyright
© 2023. The Author(s).
Références
Pathol Res Pract. 2009;205(8):579-81
pubmed: 19232839
Hemodial Int. 2007 Oct;11(4):430-4
pubmed: 17922740
Dis Mon. 2018 Jul;64(7):333-343
pubmed: 29525375
BMC Nephrol. 2013 Jan 16;14:15
pubmed: 23324652
J Chin Med Assoc. 2018 Dec;81(12):1027-1032
pubmed: 29778548
Anaesthesia. 2017 Jun;72(6):714-718
pubmed: 28332186
J Nephrol. 2015 Apr;28(2):235-43
pubmed: 25185727
Semin Dial. 2009 May-Jun;22(3):279-86
pubmed: 19573008
Semin Thromb Hemost. 2004 Oct;30(5):579-89
pubmed: 15497100
Clin Appl Thromb Hemost. 2013 Jul-Aug;19(4):449-52
pubmed: 23463188
Pediatr Nephrol. 1995 Dec;9(6):756-62
pubmed: 8747122
EPMA J. 2016 Mar 20;7:7
pubmed: 26998186
J Vet Intern Med. 2017 Sep;31(5):1414-1419
pubmed: 28833548
Am J Kidney Dis. 2013 May;61(5):845
pubmed: 23582253
Case Rep Nephrol Dial. 2019 Aug 28;9(2):119-125
pubmed: 31616672
J Transl Int Med. 2017 Jun 30;5(2):106-111
pubmed: 28721343
Medicine (Baltimore). 2019 May;98(22):e15751
pubmed: 31145291
Am J Nephrol. 2012;36(5):438-43
pubmed: 23128155
N Engl J Med. 1958 Feb 6;258(6):285-6
pubmed: 13504460