Acute esophageal necrosis: An update

Inayat, Faisal; Hurairah, Abu; Virk, Hafeez Ul Hassan

doi:10.4103/1947-2714.187159

Cited by 11 publications

(16 citation statements)

References 14 publications

(26 reference statements)

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“… 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%

“…A clinician must consider AEN when faced with an elderly, possibly poorly controlled diabetic patient presenting with acute upper gastrointestinal bleeding and hypotension/shock, particularly in the setting of chronic illness or when additional significant comorbid conditions are present. 4-6 , 8 Despite its rarity, prompt diagnosis is imperative as AEN portends a significant increase in overall mortality.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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%

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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“…There are two unique elements to this case. First, AEN is a rare disorder, [5, 6] and, when found, is associated with a high mortality rate [5, 7]. The reported high mortality probably reflects two features.…”

Section: Discussionmentioning

confidence: 99%

“…Hematemesis occurs in approximately 70% of cases. Other presenting features include vomiting, retrosternal chest discomfort, and dysphagia [1, 6]. Her diarrhea was likely a cofactor in her dehydrated state and may have been operative in the chronicity of her intravascular fluid balance.…”

Section: Discussionmentioning

confidence: 99%

Black Esophagus: A Rare Case of Acute Esophageal Necrosis Induced by Diabetic Ketoacidosis in a Young Adult Female

Field

Kropf

Lytle

et al. 2018

Case Reports in Gastrointestinal Medicine

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Background Acute esophageal necrosis is an uncommon clinical disorder diagnosed on endoscopy as a black esophagus. It has a multifactorial etiology that probably represents a combination of poor nutritional status, gastric outlet obstruction, and ischemia secondary to hypoperfusion of the distal esophagus. It typically occurs in older males with comorbidities. Case A 37-year-old woman presented with diabetic ketoacidosis and hematemesis. At esophagogastroduodenoscopy acute esophageal necrosis was diagnosed. The treatment included fluid and electrolyte management, insulin, and a proton pump inhibitor. She improved and left the hospital on day 3. Conclusion Diabetic ketoacidosis can result in a profound osmotic diuresis, fluid loss, and hypoperfusion of the distal esophagus. This condition can then lead to ischemic injury and acute esophageal necrosis. Awareness of the possibility of its presence in young women with hematemesis and poorly controlled diabetes is important since early identification with esophagogastroduodenoscopy is necessary to prevent serious postnecrotic complications.

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Acute esophageal necrosis: An update

Cited by 11 publications

References 14 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 Case of Acute Esophageal Necrosis Induced by Diabetic Ketoacidosis in a Young Adult Female

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