The Mallory Weiss Syndrome - A cause of sudden unexpected death due to massive haematemesis without antecedent vomiting

Three cases of fatal Mallory Weiss Syndrome are reported. The clinical diagnosis did not correlate with the anatomic diagnosis in any case. The classical history of repeated vomiting and retching with alcohol overindulgence followed by haematemesis was not found. The lesions found at postmortem were typical of the syndrome and considered to be the direct cause of death in both cases. A review of the literature reveals that the typical history associated with the Mallory Weiss tear is frequently not forthcoming and thus the diagnosis is not always made. Recent reports suggest that the syndrome is a benign one and not usually associated with massive Gll bleeding. This concept is not wholly true and the Mallory Weiss tear should be entertained as a possible cause of any case of massive upper Gll bleeding.