ROSH Gastrointestinal Practice Exam

Which condition is characterized by lacerations of the gastric cardia due to forceful vomiting?

1. Gastric ulcer

2. Mallory-Weiss syndrome

3. Esophageal varices

4. Acid reflux

The correct answer is: Mallory-Weiss syndrome

The condition characterized by lacerations of the gastric cardia due to forceful vomiting is Mallory-Weiss syndrome. This syndrome occurs when there is prolonged and severe vomiting, which leads to tears in the mucous membrane at the junction where the esophagus meets the stomach (the gastric cardia). The mechanism of injury in Mallory-Weiss syndrome is primarily due to the rapid increase in intra-abdominal pressure during vomiting, which overwhelms the strength of the mucosal lining and causes these lacerations. The tears can result in gastrointestinal bleeding, which may be observed as hematemesis (vomiting blood). In contrast, gastric ulcers are open sores that develop on the inner lining of the stomach, typically due to factors such as infection with H. pylori or the use of certain medications like NSAIDs. Esophageal varices are swollen veins in the esophagus that can rupture and cause severe bleeding, often associated with liver disease, not vomiting-induced lacerations. Acid reflux, or gastroesophageal reflux disease (GERD), involves the backflow of stomach contents into the esophagus, leading to symptoms like heartburn, but does not specifically cause lacerations of the gastric cardia.