Mallory-Weiss tear after violent hiccups: a rare association

Abstract

We present an unusual case of a 44-year-old male who developed violent hiccups soon after a ureteroscopy for nephrolithiasis; later, the forceful hiccups were followed by hematemesis. Upper esophagogastroduodenoscopy revealed Mallory-Weiss tears and esophageal erosions in the lower esophagus. Esophageal biopsy was unremarkable. The patient did not have a prior history of the gastrointestinal disorder. Although extracorporeal shock wave lithotripsy has on rare occasion been implicated in the development of gastrointestinal erosions, no such correlation exists for ureteroscopy and upper gastrointestinal bleeding in the management of nephrolithiasis. It was the development of violent hiccups for several hours before the onset of hematemesis that likely led to the upper gastrointestinal bleed.

Adenocarcinoma of the Gastroesophageal Junction Masquerading as Mallory-Weiss Syndrome

“…MWS most commonly results from vomiting after alcohol consumption, but no risk factor may be identified in up to 23% of cases [3]. It can also rarely be induced by cough or hiccups [19‒21], as in our case. Malignancies were found in 7 of 128 cases in 1 study [4], all of which may have contributed to vomiting but were not the direct source of bleeding from the GEJ.…”