<prompt> True about Mallory Weiss tearHamman mediastinumEsophagus perforates at all layersAuscultation - Crunching soundSymptoms improves after conservative Mx  <response>: MALLORY WEISS SYNDROME is seen in adults with severe prolonged vomiting, causing a longitudinal tear in the mucosa of the stomach at and just below the cardia, leading to severe haematemesis.Violent vomiting often may be due to a migraine or veigo or following a bout of alcohol. Presents with severe vomiting and later haematemesis, with features of shock. It is common in one Oclock position. Only 10 of cases involve lower oesophageal mucosa. Investigations employed mainly includes Gastroscopy, Hb, PCV, blood grouping. During gastroscopy, if the stomach is not inflated properly, 50 cases may be missed.Differential diagnosis - Bleeding peptic ulcer Oesophageal varices Erosive gastritis Carcinoma stomachTreatment is Conservative, as it is only a mucosal tear. Blood transfusion. IV fluids. Sedation. Haemostatic agents like vasopressin. Endoscopic injection therapy is used if required. Surgery is rarely required. Ref: SRBs manual of surgery,3 rd ed, pg no 750 