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    Mallory Weiss Tear

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    GADDAM TEJASWINI
    The document describes a 75-year-old male patient admitted to the hospital with hematemesis and malena due to Mallory-Weiss syndrome caused by a laceration at the gastroesophageal junction from large hiatus hernia and ulcers. Medical history includes Parkinson's disease, hypertension, diabetes. Treatment involved monitoring, IV medications to stop bleeding and prevent complications, and endoscopy showed hiatal hernia and Mallory-Weiss tear which require repair.

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    © All Rights Reserved
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    Mallory Weiss Tear

    Uploaded by

    GADDAM TEJASWINI
    34 views19 pages
    The document describes a 75-year-old male patient admitted to the hospital with hematemesis and malena due to Mallory-Weiss syndrome caused by a laceration at the gastroesophageal junction from large hiatus hernia and ulcers. Medical history includes Parkinson's disease, hypertension, diabetes. Treatment involved monitoring, IV medications to stop bleeding and prevent complications, and endoscopy showed hiatal hernia and Mallory-Weiss tear which require repair.

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    The document describes a 75-year-old male patient admitted to the hospital with hematemesis and malena due to Mallory-Weiss syndrome caused by a laceration at the gastroesophageal junction from large hiatus hernia and ulcers. Medical history includes Parkinson's disease, hypertension, diabetes. Treatment involved monitoring, IV medications to stop bleeding and prevent complications, and endoscopy showed hiatal hernia and Mallory-Weiss tear which require repair.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    34 views19 pages

    Mallory Weiss Tear

    Uploaded by

    GADDAM TEJASWINI
    The document describes a 75-year-old male patient admitted to the hospital with hematemesis and malena due to Mallory-Weiss syndrome caused by a laceration at the gastroesophageal junction from large hiatus hernia and ulcers. Medical history includes Parkinson's disease, hypertension, diabetes. Treatment involved monitoring, IV medications to stop bleeding and prevent complications, and endoscopy showed hiatal hernia and Mallory-Weiss tear which require repair.

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    SUBMITTED BY – GADDAM TEJASWINI

    DOCTOR OF PHARMACY-4th YEAR


    16Z91T0011
    SUBMITTED TO- DR.B.HEPSHIBHA
    DEPT. OF CLINICAL PHARMACY
    Mallory–Weiss syndrome
     Mallory–Weiss syndrome or gastro-
    esophageal laceration syndrome refers to
    bleeding from a laceration in the mucosa at
    the junction of the stomach and esophagus.
    The syndrome presents with hematemesis.
    PATIENT DETAILS:-
     NAME – ABCD
     AGE – 75 Years
     GENDER - Male
     WEIGHT – 65 Kgs
     IP NO. – ASIP190000661
     DOA – 23/09/2019
    REASONS FOR ADMISSION :
     C/O – Hematemesis (3 to 4 episodes in
    last 24 hrs) , malena
     H/O – large hiatus hernia, 2 deep linear
    ulcers @ Z line , parkinsonism ,
    hypertension, diabetics mellitus
     PMHx :

    T.Gluconorm SR 500 mg – DM-type


    II
    T.Met XL – trio 25mg – hypertension
    T.Minipress XL 5mg - hypertension
    T.Tegrital – 200 mg – trigeminal
    neuralgia
    T.Clopitab 75mg - antiplatelet
     Diet – mixed
     Allergies – not significant
     SHx – not significant
     Social Hx – smoker- 10 yrs
    General examination
     Patient conscious and mild disorientation
     Gait – Shuffling gait with tendency to fall
    forward and backward
     Temp – 98.6 F
     Pulse – 112 / min
     BP – 170 / 11o mmHg
     RESP – 22
     SP02 – 100%
     CVS – S1
    Advice
     Complete blood picture
     Troponin T
     Kidney function test
     Blood glucose
     2 D Echo Doppler
     Endoscopy
     USG
     ECG
    COMPLETE BLOOD PICTURE
    COMPONENTS REFERENCE 23/09 24/09 25/09 26/09

    HEMOGLOBIN 13-17 g/dl 8.8 7.5 7.8 9.3

    RBC 4.5 – 5.5 million /mm3 2.7 2.3 2.5 2.9

    PCV 40- 50% 25 21 22 26

    WBC 4000 – 10000 cells/ 16400 13400 13400 12900


    mm3
    NEUTROPHILS 40-80% 85 85 84 84

    LYMPOCYTES 20-40% 10 10 10 10

    MCHC 32-35 g/dl 30 30 31 35


    COMPONENTS REFERENCE 23/09 24/09 25/09

    Blood urea 13 – 43 mg/dl 126 58 26

    Creatinine 0.7 – 1.3 mg/dl 1.1 0.7 0.7

    Na+ 136 – 145 mEq/L 135 139 134

    k+ 3.5 – 5.1 mEq/L 4.9 3.5 3.7

    cl- 98-107mEq/L 100 103 98

    Total proteins 6-8g/dl 5.4

    Albumin 3.5 – 5.2 g/dl 3.3

    Globulin 2.3 – 3.5g/dl 2.1


    COMPONENT REFERENCE VALUE
    TROPONIN((HIGH 11.2mg/ml 0-14
    SENSITIVE)
    COMPONENT REFERENCE VALUE
    HbA1C >6.5 diabetic 5.4%
    Fasting blood 80-120mg/dl 163
    glucose
    LIPID PROFILE
    COMPONENT REFERENCE VALUE

    TOTAL <200mg/dl 120mg/dl


    CHOLESTEROL
    HDL <40 POOR 27mg/dl
    DIRECT LDL <100 – for diabetes 69mg/dl
    and heart
    VLDL 2-30 mg/dl 24mg/dl
    CHOLESTEROL
    TRIGLYCERIDES Less than 15 normal 118mg/dl
     USG – Hepatomegaly with fatty infiltration,
    cholelithiasis, thick walled UB with BPM
     2-D ECHO DOPPLER - Gr – 1 Lv diastolic
    dysfunction
     ENDOSCOPY – Large hiatus hernia, Mallory
    Weiss tear
    TREATMENT
     DAY 1
    DRUG DOSE ROUTE FREQENCY

    INJ. MONOCET Igm Iv 1-0-1

    INJ.NEKSIUM 80mg Iv 0-0-1

    INJ.XAMIC 500mg iv 1-1-1

    INJ.VIT K 10mg iv 0-1-0

    INJ.ZOFER 4g iv sos

    INJ.LASIX 20mg iv start

    TAB.PROLOMET-XL 25mg p/o 0-1-0

    TAB.SYNDOPA PLUS 100mg p/o 1-0-1

    INJ.TERLYZ WITH 1mg iv stat


    100ml
     20 pcv reserved.
     DAY- 2-
    ADV- to stop xamic
    and to add T.Ropinirole – 0.5mg p/o
    0-0-1
    to add hinex st with water p/o
    3scoops -1-1-1
    and add tab.urimax –d p/o 0-1-0
    • DAY-3 :- Same
    • DAY 4 :- adv to add Duphalac 30ml 0-0-1
    GOALS OF THE TREATMENT:
    • To relieve signs and symptoms (malena,
    Hematemesis )
    • To prevent further complications
    • Maintain overall quality of life
    • Reduce tremor
    • Reverse slowed movements.
    • Improve posture, gait, balance, speech, and
    writing skills.
    • Improve mobility and function.
    • minimizing medication side effects
    • to remove the hernia sac and close the
    abnormally wide esophageal hiatus
    MONITORING PARAMETERS
     Blood pressure
     Diabetes mellitus
     Adr’s
     Complete blood picture
     movement
    PATIENT COUNSELLING:-
     About the disease:
    Signs and symptoms
    Prognosis
    Complications
     About the medication
    Medication adherence(dose, frequency)
    Adr’s
     About the life style modification
    Quit smoking

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