Acute Esophageal Necrosis: A Case Series

Averbukh, Leon D.; Mavilia, Marianna G.; Gurvits, Grigoriy E.

doi:10.7759/cureus.2391

Cited by 12 publications

(19 citation statements)

References 7 publications

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“…A case classified in the endoscopy series, reported by Averbukh et al (Averbukh et al 2018) illustrates this hypothesis. A 54-year-old man was found unresponsive in a parking lot.…”

Section: Discussionmentioning

confidence: 85%

“…He had a history of repeated hematemesis and was known for alcohol abuse and recurrent pancreatitis. If he had not have been found at the parking lot, he would probably have died there (Averbukh et al 2018).…”

Section: Discussionmentioning

confidence: 99%

“…Case reports published in literature reviews were also included on the condition that patient history was sufficiently detailed. The endoscopy series initially included 88 publications, of which 26 publications on a total of 41 deceased patients were retained (Gurvits et al 2015;Ben Soussan et al 2002;Averbukh et al 2018;Barnes et al 2014;Day and Sayegh 2010;Del Hierro 2011;Essamri et al 2001;Grudell et al 2006;Julian Gomez et al 2008;Kalva et al 2016;Katsinelos et al 2004;Koop et al 2016;Lahbabi et al 2013;Maher and Nassar 2008;Odelowo et al 2002;Ramos et al 2008;Rodrigues et al 2016;Roman Fernandez et al 2014;Salem et al 2015;Shafa et al 2016;Shah et al 2017;Sharma et al 2016;Singh et al 2011;Wu and Wu 2014;Monteiro et al 2019;Khan et al 2019). The autopsy series initially comprised 13 publications, of which 11 publications on a total of 17 patients were retained in this review.…”

Section: Literature Review Methodsmentioning

confidence: 99%

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Black esophagus as an autopsy discovery: a challenging interpretation

Kerschen

Schmit

Boosere

et al. 2020

Egypt J Forensic Sci

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Black esophagus is a rare medical condition, characterized by a circumferential blackish discoloration of the distal part of the esophageal mucosa, abruptly ending at the gastroesophageal junction. The etiology is multifactorial since patients suffer from multiple comorbidities. While the mortality rate specifically linked to black esophagus is only around 6%, the mortality rate linked to the underlying comorbidities amounts to 32%. A series of five cases is provided in which black esophagus was an unexpected discovery at autopsy. Black esophagus is generally considered being a challenge to the forensic pathologist. There are often no other major gross anomalies found at autopsy and information about the patient's medical history is not always available, which complicates a correct assessment. We present a review of the literature on black esophagus, limited to reports on deceased patients. The reviewed publications are divided into autopsy and endoscopy series to correctly compare the causes of death. The aim of this review is to identify a possible divergence in causes of death in autopsy and endoscopy series and additionally to analyze the causes of these differences to enable better assessment and interpretation of black esophagus at forensic autopsies. This paper emphasizes the importance of a minimal knowledge of the victim's comorbidities and medical record and the use of toxicology and postmortem biochemistry analysis as a valuable tool in investigating the cause of death in the setting of black esophagus.

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“…A case classified in the endoscopy series, reported by Averbukh et al (Averbukh et al 2018) illustrates this hypothesis. A 54-year-old man was found unresponsive in a parking lot.…”

Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Literature Review Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Black esophagus as an autopsy discovery: a challenging interpretation

Kerschen

Schmit

Boosere

et al. 2020

Egypt J Forensic Sci

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“…AEN is a rare cause of severe injury to the esophagus [7][8][9][10][11][12][13]. It has an endoscopic appearance characterized by diffuse, circumferential black discoloration of the mucosa that affects the distal esophagus and stops abruptly at the gastroesophageal junction [1][2][3][4][5][6][7].…”

Section: Discussionmentioning

confidence: 99%

“…It has been postulated that gastroesophageal acid reflux disrupts the intrinsic mucosal barriers of the esophagus and causes mucosal injury, while the limited blood supply of the distal esophagus can lead to esophageal necrosis when there is hemodynamic instability. Those who suffer from AEN often have significant comorbidities or are critically ill [8,9]. Septic shock or acutely decompensated heart failure can lead to hypoperfusion states that predispose patients to necrotizing esophagitis [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Black Esophagus in the Setting of Diabetic Ketoacidosis: A Rare Finding from Our Institution

Ghoneim

Shah

Dalal

et al. 2019

Case Rep Gastroenterol

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Acute esophageal necrosis (AEN) is defined as necrosis of the esophageal mucosa seen as diffuse black discoloration of the distal esophagus on an upper endoscopy. The prevalence of the disease is rare and reported to be up to 0.2% in autopsy series. The etiology of the disease is thought to be multifactorial and due to ischemic insults to the esophagus with gastric acid reflux further damaging the vulnerable mucosa. Patients are often critically ill or with significant comorbidities. Here, we present a case series of 3 patients with AEN induced by diabetic ketoacidosis.

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Evaluation of prognostic factor and nature of acute esophageal necrosis

et al. 2019

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Acute esophageal necrosis (AEN) is a serious disease which can causes gastrointestinal bleeding and death. Although black color change is not essential factor of organ necrosis, AEN is also known as “black esophagus.” Because of its rarity, there are limited studies regarding risk factors of mortality and recurrence. Thus, we conducted a multicenter retrospective study in order to evaluate the clinical characteristics of AEN. Method Clinical datum of AEN patients from 7 tertiary hospitals located in Daejeon-Choongcheong province were evaluated based on medical records. Our primary endpoint was risk factors for mortality and the secondary endpoint was risk factors for recurrence and clarifying whether “black esophagus” is a right terminology.Fourty one patients were enrolled. Thirty six patients were male, mean age was 69.5 years. Nine patients had died, and 4 patients showed recurrence. Sepsis and white color change in endoscopy were related to high mortality (Chi-Squared test, P < .05). Old age, high pulse rate, low hemoglobin, and low albumin were also related to high mortality. Unexpectedly, heavy drinking showed favorable a mortality. Septic condition and high pulse rate showed poor mortality in logistic regression test (P < .05). Coexisting duodenal ulcer was related to recurrence (Chi-Squared test, P < .05). There was no difference in the underlying condition except patients with a coexisting cancer and white-form displayed lower hemoglobin level. Conclusion: Our results imply that white color change, septic condition, high pulse rate, and low hemoglobin & albumin are poor prognostic factors in AEN. Further evaluation may help clarify the findings of our study.

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Acute Esophageal Necrosis: A Case Series

Cited by 12 publications

References 7 publications

Black esophagus as an autopsy discovery: a challenging interpretation

Black esophagus as an autopsy discovery: a challenging interpretation

Black Esophagus in the Setting of Diabetic Ketoacidosis: A Rare Finding from Our Institution

Evaluation of prognostic factor and nature of acute esophageal necrosis

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