Mallory Weiss syndrome is not associated with hiatal hernia: a matched case–control study

Background/objective: Hiatal hernia is considered to be a predisposing factor to develop Mallory-Weiss Syndrome (MWS). No large case–control studies verifying this hypothesis have been conducted. Methods: We reviewed all esophagogastroduodenoscopies with findings of MWS (n = 2342) in a national database and compared with age and gender-matched controls (n = 9368). Demographics, endoscopic characteristics and presence of a hiatal hernia were compared between both groups. Average age was 56.7 ± 18.6 years, and 72.4% were male. Results: Hiatal hernia was more common in controls, and no significant difference was seen in a multivariate analysis. Conclusion: Dynamic changes inducing mucosal tension are more relevant determinants to develop MWS than gastro-esophageal junction location alone.