Esófago negro secundario a esofagitis necrotizante aguda: Reporte de un caso clínico

Abstract

Black esophagus due to acute necrotizing esophagitis. Report of one case Acute esophageal necrosis, which presents as a black esophagus on endoscopy, is an uncommon occurrence. It is defined as a dark pigmentation of the esophagus associated with histologic mucosal necrosis. We report a 75-year-old men who developed black esophagus due to acute esophageal necrosis caused by septicemia. The patient had a favorable evolution (Rev Méd Chile 2009; 137: 672-4).

Comment on the clinical note: Acute necrotizing esophagitis in an unstable patient.

“…Wallberg et al reported similar favorable outcome of BE in a 75-old-year patient with sepsis 4 , which is a major cause of systemic inflammatory response and circulatory failure. Common clinical features are dyspepsia, epigastralgia, hematemesis, melena, and vomiting, but the diagnosis suspicion of BE during endoscopy must be further confirmed by histological data.…”

“…Worth of note, only about a hundred cases of this entity were reported since the first description in 1990 [1][2][3][4] ; notwithstanding, published necropsy data are suggestive that BE may be under diagnosed and/or under reported 2,5 . The aim of the present paper is to enhance the suspicion index about BE, which will have better outcome if early diagnosis and precocious treatment can be accomplished.…”

“…Malignancies found in patients with BE are: cancers from colon, biliary tract, hypofarynx, lung, ovary, pancreas, prostate, and rabdomyosarcoma. Esophageal stricture is the major complication 2,4 . Figure 1a.…”

“…TC showed perirectal invasion and liver implants. Remarkable laboratory data were hypoalbuminemia, accentuated anemia and leukocytosis with neutrophilia, in addition to hyponatremia and high platelet count [1][2][3][4] . These changes can be found in acute phase response (APR) and protein-energy malnutrition (PEM) 6,7 .…”

“…Common clinical features are dyspepsia, epigastralgia, hematemesis, melena, and vomiting, but the diagnosis suspicion of BE during endoscopy must be further confirmed by histological data. Circumferential black discoloration is often seen in distal esophagus, with mucosa erosions, ulcers, exudates, necrosis and vessel thrombi [1][2][3][4] . Differential diagnosis of BE includes acanthosis nigricans, melanoma, melanosis, pseudomelanosis, ocronosis and necrotic lesions due to caustic or corrosive agents [1][2][3][4] .…”