Cytomegalovirus Acute Necrotizing Esophagitis

Barjas, Elídio; Pires, Sara; Lopes, Joanne; Valente, A.; Oliveira, E.P.; Palma, Robert; Raimundo, M.; Alexandrino, Paula; Moura, Marta Casal

doi:10.1055/s-2001-16215

Cited by 14 publications

(5 citation statements)

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“…Possible agents may include cytomegalovirus, 12 herpes simplex virus, 6 and certain types of fungus. 1,36 Detection of inclusion bodies 12 and multinucleated giant cells may aid in early diagnosis. 6 Antibiotic therapy in AEN is controversial.…”

Section: Discussionmentioning

confidence: 99%

Acute esophageal necrosis: a rare syndrome

et al. 2007

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This study provides a structured approach to identifying risk factors, diagnosis, and pathogenesis of the acute esophageal necrosis. Risk factors include age, male sex, cardiovascular disease, hemodynamic compromise, gastric outlet obstruction, alcohol ingestion, malnutrition, diabetes, renal insufficiency, hypoxemia, hypercoagulable state, and trauma. Mechanism of damage is usually multifactorial secondary to ischemic compromise, acute gastric outlet obstruction, and malnutrition. Overall, acute esophageal necrosis should be viewed as a poor prognostic factor, associated with high mortality from the underlying clinical disease.

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Section: Discussionmentioning

confidence: 99%

Acute esophageal necrosis: a rare syndrome

et al. 2007

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“…AEN may be associated with local infection of the esophagus, with reported pathogens including herpes simplex virus 1 [63,64], cytomegalovirus [65-67], Klebsiella pneumoniae [68], Actinomyces [69], Penicillium chrysogenum [70] and Candida [71]. These may be the result of the external spread of contiguous infectious processes [68], or opportunistic primary esophageal intraluminal infections in immunocompromised patients [65-67,70]. Therefore, although not required to establish diagnosis, tissue biopsy is essential to identify local infection and provide proper management with directed antimicrobial therapy.…”

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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“…There is also a possible link between AON and certain pathogens, such as cytomegalovirus,7 8 Candida albicans 9 10 and Klebsiella pneumoniae 11…”

Section: Discussionmentioning

confidence: 99%

Acute oesophageal necrosis syndrome

Garas

Wou²,

Sawyer³

et al. 2011

Case Reports

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An 89-year-old woman with a known hiatus hernia presented to the accident and emergency department with acute onset epigastric pain. CT of the thorax and abdomen revealed a large hiatus hernia with mesentero-axial volvulus but no evidence of strangulation. A large aneurysmal aortic arch and descending aorta were visible with associated mural thrombus. As the pain was worsening, following discussion with the patient, the decision to operate was taken. The hiatus hernia was successfully reduced and the stomach looked healthy. The oesophagus, however, appeared black almost throughout its entire length consistent with acute oesophageal necrosis syndrome, a rare and lethal disease. Left lateral thoracotomy followed by cervicotomy was performed to retrieve a healthy oesophageal segment, which was anastomosed to the cardiac end of the stomach. Despite treatment in the intensive care unit, the patient's condition progressively deteriorated and she died of multiorgan failure 12 days later.

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Cytomegalovirus Acute Necrotizing Esophagitis

Cited by 14 publications

References 0 publications

Acute esophageal necrosis: a rare syndrome

Acute esophageal necrosis: a rare syndrome

Diagnosis and management of acute esophageal necrosis

Acute oesophageal necrosis syndrome

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