Acute Necrotizing Esophagitis Followed by Duodenal Necrosis

Hierro, Piedad Magdalena del

doi:10.4021/gr361w

Cited by 7 publications

(8 citation statements)

References 15 publications

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“…Relapse after complete recovery is not typical, although it has been documented [82]. There is also one case of isolated duodenal necrosis 4 months after an episode of AEN [113].…”

Section: Etiologymentioning

confidence: 99%

Diagnosis and management of acute esophageal necrosis

Dias

Santos-Antunes

Macedo

2019

aog

113

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Acute esophageal necrosis is a rare syndrome classically characterized by a striking endoscopic image of diffuse and circumferential black mucosal discoloration of distal esophagus, with an abrupt transition at the gastroesophageal junction and variable proximal extension. The typical patient is an older male with general debilitation and multiple comorbidities presenting with hematemesis or melena. The pathophysiology usually involves a combination of esophageal ischemia, backflow injury from gastric chemical contents and impaired mucosal reparative mechanisms associated with debilitated physical states. It may arise in the setting of hemodynamic compromise, diabetic ketoacidosis, hypothermia, alcoholic intoxication, trauma, inflammatory diseases, esophageal local infection, solid organ transplantation, postoperative status, drugs or acute gastric outlet obstruction, usually in the background of a chronic debilitating process, where the concurrent presence of multiple risk factors, including diabetes mellitus, hypertension, malnutrition, malignancy or alcohol abuse, places a patient at higher risk. The characteristic endoscopic appearance establishes the diagnosis. Biopsy is supportive but not required. Management is mainly supportive and consists of correcting coexisting conditions, fluid therapy, bowel rest, intravenous proton pump inhibitor therapy and red blood cell transfusion as needed. Although this is a serious life-threatening condition, appropriate treatment may result in a favorable outcome in the majority of patients.

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“…Relapse after complete recovery is not typical, although it has been documented [82]. There is also one case of isolated duodenal necrosis 4 months after an episode of AEN [113].…”

Section: Etiologymentioning

confidence: 99%

Diagnosis and management of acute esophageal necrosis

Dias

Santos-Antunes

Macedo

2019

aog

113

View full text Add to dashboard Cite

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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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“…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%

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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Acute Necrotizing Esophagitis Followed by Duodenal Necrosis

Cited by 7 publications

References 15 publications

Diagnosis and management of acute esophageal necrosis

Diagnosis and management of acute esophageal necrosis

Comprehensive review of acute oesophageal necrosis

Black esophagus as an autopsy discovery: a challenging interpretation

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