Use of the Ella Danis stent in severe esophageal bleeding caused by acute necrotizing esophagitis

Messner, Z; Gschwantler, Michael; Resch, H.; Bodlaj, Gerd

doi:10.1055/s-0034-1365384

Cited by 9 publications

(5 citation statements)

References 5 publications

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“…Active esophageal bleeding, if present, can be controlled with submucosal adrenaline injection [36,61]. Endoscopic placement of a self-expandable metallic covered stent is another effective strategy for achieving hemostasis [114]. Balloon tamponade with a Sengstaken-Blakemore tube should be avoided, because it has been associated with perforation [115].…”

Section: Managementmentioning

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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Section: Managementmentioning

confidence: 99%

Diagnosis and management of acute esophageal necrosis

Dias

Santos-Antunes

Macedo

2019

aog

113

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“…The use of fully covered esophageal stent for management of AEN to stop bleeding was reported to avoid the risk of perforation from clipping or injection. 12 To our knowledge, this is the first case report where a fully covered SEMS was used to control bleeding in the setting of AEN.…”

Section: Discussionmentioning

confidence: 88%

Endoscopic Treatment of Black Esophagus With Fully Covered Metallic Stent

Bayati

Badhiwala

Obaidi

et al. 2022

Journal of Investigative Medicine High Impact Case Reports

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Acute esophageal necrosis (AEN) is a condition characterized by black appearance and inflammation of the esophagus. Our patient developed AEN presenting in the setting of alcohol intoxication and extensive inferior vena cava thrombosis. Esophagogastroduodenoscopy showed blood and black discoloration of the middle and lower esophagus with oozing. To control bleeding, a self-expandable fully covered metallic esophageal stent was placed. Multiple studies and reviews agree that the initial management for AEN is supportive care, resuscitation, and proton pump inhibitors to protect the esophageal mucosa from injury from acid reflux. Our case highlights the benefits of esophageal stent placement to manage AEN with active bleeding.

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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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Use of the Ella Danis stent in severe esophageal bleeding caused by acute necrotizing esophagitis

Cited by 9 publications

References 5 publications

Diagnosis and management of acute esophageal necrosis

Diagnosis and management of acute esophageal necrosis

Endoscopic Treatment of Black Esophagus With Fully Covered Metallic Stent

Comprehensive review of acute oesophageal necrosis

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