Anatomical Location of Mallory-Weiss Tears
Mallory-Weiss tears are typically located at or near the gastroesophageal junction, most commonly on the posterior aspect, and can extend just distal into the gastric cardia. 1
Specific Anatomical Distribution
The tears characteristically occur posteriorly across the gastroesophageal junction, representing the most common location for these mucosal lacerations 1
Approximately 68% of lacerations are found just distal to the esophago-cardial junction (the gastric side of the junction) 2
When tears occur in the gastric cardia, they appear more frequently on the right lateral wall than the left lateral wall 2
Single tears are the most common presentation, though multiple lacerations can occur 2
Pathophysiologic Context
These mucosal lacerations result from forceful retching or vomiting, which causes a sudden increase in intra-abdominal pressure transmitted to the gastroesophageal junction 1, 3
The longitudinal orientation of the tears reflects the mechanical stress pattern at this anatomical location during episodes of forceful vomiting 4
Clinical Significance of Location
The gastroesophageal junction location makes these tears readily accessible to endoscopic visualization and treatment during esophagogastroduodenoscopy 4
The posterior location at the gastroesophageal junction is a key endoscopic finding that confirms the diagnosis when visualized during upper gastrointestinal endoscopy 1
Risk factors that may alter the typical location include hiatal hernia and atrophic gastritis, which can occasionally result in tears extending further into the stomach 3