Acute Esophageal Necrosis: An Uncommon Cause of Hematemesis

Zacharia, George Sarin; Sandesh, K; Ramachandran, Thazhath Mavali

doi:10.5001/omj.2014.79

Cited by 11 publications

(16 citation statements)

References 8 publications

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“…Additional risk factors include malignancy, cirrhosis, chronic pulmonary disease, renal failure, vascular or cardiac disease, diabetes mellitus, immunosupression or immunodeficiency, recent surgical procedure, and sepsis. 5 , 6 Based on review of the literature, there appears to be a particularly strong association of AEN with diabetic ketoacidosis (DKA) in the setting of acute gastrointestinal bleeding. 5 , 8 …”

Section: Discussionmentioning

confidence: 99%

Acute Esophageal Necrosis: A Rare Case of Upper Gastrointestinal Bleeding from Diabetic Ketoacidosis

Uhlenhopp

Pagnotta

Sunkara

2020

Clinics and Practice

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Acute esophageal necrosis, also known as black esophagus or acute necrotizing esophagitis is a rare condition with roughly 154 cases reported in the literature. This condition is classically diagnosed on its endoscopic findings of a circumferentially black esophagus that abruptly ends at the gastroesophageal junction and transitions to normal gastric mucosa. When present, acute esophageal necrosis potentially signifies a poor prognosis with an overall mortality up to 36%. This case report describes a critically ill patient with multiple comorbidities that was found to have acute esophageal necrosis the entire length of the esophagus secondary to ischemia/hypoperfusion that was caused by diabetic ketoacidosis. The patient had a prolonged hospitalization but was ultimately discharged in stable condition. We also review the literature of this rare esophageal condition.

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Section: Discussionmentioning

confidence: 99%

Acute Esophageal Necrosis: A Rare Case of Upper Gastrointestinal Bleeding from Diabetic Ketoacidosis

Uhlenhopp

Pagnotta

Sunkara

2020

Clinics and Practice

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“…Of these cases, we managed to extract data from 79 articles having 105 cases of AON (online supplementary table 1). 5–82 Data could not be extracted from (n=13) of the articles containing a total of (n=20) cases 4 83–95. The most common reasons for these were unavailability of complete data or the language being other than English.…”

Section: Discussionmentioning

confidence: 99%

Comprehensive review of acute oesophageal necrosis

Ullah¹,

Mehmood

Micaily

et al. 2019

BMJ Case Rep

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Acute oesophageal necrosis, also known as ‘black oesophagus’, is a rare condition characterised by the black discolouration of the oesophageal mucosa on endoscopy and involves the distal oesophagus in majority of cases but may also extend proximally. A number of conditions are found to be associated with it and it is thought to occur due to a combination of hypovolaemia and inadequate oesophageal protective mucosal barrier function. Gastric secretions may have a direct effect on the oesophageal mucosa. We present a case of a woman who presented with haematemesis and significant hypotension after a session of haemodialysis. Black oesophagus was confirmed on esophagogastroduodenoscopy. She was given two units of packed red blood cells and one unit of platelets, and started on a pantoprazole infusion. However, despite rigorous attempts at resuscitation the patient failed to recover.

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“…Patients with black esophagus typically present for evaluation as a result of GI bleeding, which occurs in 65% to 90% of cases. 9,10 This condition is more common in elderly patients with a disproportionately higher incidence in men, who represent approximately 80% of cases. A variety of comorbidities are associated with AEN, most commonly diabetes mellitus, malignancy, hypertension, renal insufficiency, heart disease, and duodenal ulcer.…”

Section: Discussionmentioning

confidence: 99%

Black Esophagus: A Rare Cause of Gastrointestinal Hemorrhage in the Emergency Department

Arthur¹,

Caro²,

Lester³

et al. 2018

Emerg Med

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A 65-year-old man presented to the ED for evaluation of a 1-week history of intermittent, exertional syncope and coffee ground emesis. His medical history was significant for hypertension, peripheral vascular disease, hyperlipidemia, and peptic ulcer disease. Although his social history was positive for alcohol use and abuse, the patient stated that he had not consumed any alcoholic beverages since the onset of nausea and vomiting. A review of the patient's systems was positive for lightheadedness upon standing and for palpitations. He had no prior history of melena, hematochezia, or syncope, but did report a previous history of upper gastrointestinal (GI) bleeding due to peptic ulcer disease and alcohol abuse. The patient's vital signs at presentation were: blood pressure (BP), 114/74 mm Hg; heart rate, 112 beats/min; respiratory rate, 15 breaths/min; and temperature, 97.7°F. Oxygen saturation was 97% on room air. On examination, the patient was conversant and oriented. He had dried blood around his mouth and chin from vomiting and appeared ill but nontoxic. His mucous membranes were pale. The cardiopulmonary examination was remarkable for tachycardia; however, the patient's extremities were warm and his capillary refill time was normal. The rectal examination was notable for melenic stool, which was guaiac positive. During the patient's course in the ED, he passed a large, melenic stool. The remainder of the physical examination was normal. The chest X-ray was normal, but the electrocardiogram demonstrated sinus tachycardia. Laboratory studies were remarkable for the following: In this case presentation of a 65-year-old man who presented to the ED for evaluation of a 1-week history of intermittent coffee-ground emesis and syncope, the authors review the literature about a rare, but potentially fatal diagnosis.

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Acute Esophageal Necrosis: An Uncommon Cause of Hematemesis

Cited by 11 publications

References 8 publications

Acute Esophageal Necrosis: A Rare Case of Upper Gastrointestinal Bleeding from Diabetic Ketoacidosis

Acute Esophageal Necrosis: A Rare Case of Upper Gastrointestinal Bleeding from Diabetic Ketoacidosis

Comprehensive review of acute oesophageal necrosis

Black Esophagus: A Rare Cause of Gastrointestinal Hemorrhage in the Emergency Department

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