scholarly journals Acute Esophageal Necrosis: A View in the Dark

2019 ◽  
Vol 13 (1) ◽  
pp. 25-31 ◽  
Author(s):  
Hafiz Khan ◽  
Moiz Ahmed ◽  
Magda Daoud ◽  
Jobin Philipose ◽  
Saba Ahmed ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Upper Gastrointestinal Bleeding ◽  
Low Flow ◽  
Esophageal Disease ◽  
Esophageal Mucosa ◽  
Acute Esophageal Necrosis ◽  
Esophageal Necrosis ◽  
Upper Gastrointestinal

Acute esophageal necrosis (AEN), also known as Gurvits syndrome, black esophagus, or acute necrotizing esophagitis, is a rare clinical entity and an unusual reason for upper gastrointestinal bleeding. It is typically described in critically ill patients with multiple medical conditions, arising from a combination of ischemic insult to the esophageal mucosa due to low-flow vascular states, corrosive injury caused by reflux of acid and pepsin, and decreased function of the mucosal barrier systems and reparative mechanisms as occurs in malnourished and debilitated physical states. Patients with AEN tend to be older men, as medical comorbidities including vascular disease, diabetes, hypertension, renal insufficiency, cardiac disease, pulmonary disease, stroke, and cirrhosis may be more common. Typically, patients present with upper gastrointestinal bleeding, and hematemesis or melena is seen in up to 90% of cases. Herein we present 3 cases of AEN in critically ill patients. We also provide a review of the literature to highlight what is currently known about this relatively uncommon esophageal disease.

scholarly journals A199 BLACK ESOPHAGUS: AN UNDER-RECOGNIZED CAUSE OF UPPER GASTROINTESTINAL BLEEEDING

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 72-73
Author(s):  
A Arora ◽  
K Tsoi
Keyword(s):  
Gastrointestinal Bleeding ◽  
Nasogastric Tube ◽  
Upper Gastrointestinal Bleeding ◽  
Diabetic Patients ◽  
Upper Endoscopy ◽  
Acute Esophageal Necrosis ◽  
Esophageal Necrosis ◽  
Black Esophagus ◽  
Coffee Ground ◽  
Upper Gastrointestinal

Abstract Background “Black esophagus” is a term that refers to the endoscopic manifestation of acute esophageal necrosis (AEN), a rare but potentially under-recognized cause of upper gastrointestinal bleeding, characterized by the presence of strikingly black necrotic esophagus on upper endoscopy. The etiology is unclear although ischemic insults and caustic injury from gastric acid exposure are thought to play prominent roles. This condition is often seen in patients who are systemically unwell and have underlying comorbidities such as diabetes mellitus and vascular diseases. Aims We present a case of an elderly woman with diabetes and poor glycemic control who developed coffee ground emesis with her upper endoscopy revealing evidence of acute esophageal necrosis. AEN is an important diagnosis to consider in diabetic patients, as it generally carries a poor prognosis with mortality rates as high as 32% reported in the literature. Methods Case report and review of the literature Results A 61-year-old woman with medical history significant for poorly controlled insulin dependent diabetes (hemoglobin A1c, 11%) developed coffee ground emesis (confirmed via insertion of nasogastric tube) three days after initial admission to hospital for left tibial plateau fracture. Her bloodwork did not reveal any underlying diabetic ketoacidosis or hyperosomlar hyperglycemic state. Her esophagogastroduodenoscopy (EGD) showed black, necrotic-appearing discoloration of the esophageal mucosa circumferentially within the mid to distal part of the esophagus with a sharp transition point towards normal appearing mucosa at the gastroesophageal junction. Biopsies were deferred due to high risk of bleeding and perforation, and the previously placed nasogastric tube was not removed. After endoscopy, conservative management was advised with restricted oral intake, intravenous proton pump inhibitor (PPI) inhibitor therapy for 72 hours and aggressive treatment of ongoing hyperglycemia. There were no signs or symptoms of esophageal rupture. The patient gradually recovered and in fact had her orthopedic surgery within a week of EGD. Furthermore, three days into the post operative period she developed venous thromboembolism and was placed on full dose oral anticoagulation and tolerated this without any further gastrointestinal bleeding. Conclusions AEN is an important diagnostic consideration in elderly diabetic patients presenting with acute upper gastrointestinal bleeding, particularly as timely recognition and management can significantly lower the unfavorable mortality associated with this condition. Funding Agencies None

scholarly journals Acute esophageal necrosis (black esophagus) with active upper gastrointestinal bleeding: What to do?

Endoscopy ◽  
2021 ◽  
Author(s):  
Igor Braga Ribeiro ◽  
Gustavo de Oliveira Luz ◽  
Gabriel Mayo Vieira de Souza ◽  
Mateus Bond Boghossian ◽  
Epifânio Silvino do Monte Junior ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Acute Esophageal Necrosis ◽  
Esophageal Necrosis ◽  
Black Esophagus ◽  
Upper Gastrointestinal

Does antacid prophylaxis prevent upper gastrointestinal bleeding in critically ill patients?

1985 ◽  
Vol 13 (8) ◽  
pp. 646-650 ◽  
Author(s):  
JAIME C PINILLA ◽  
FREDRICK H. OLENIUK ◽  
DIANE REED ◽  
BHARAT MALIK ◽  
WILLIAM H. LAVERTY
Keyword(s):  
Gastrointestinal Bleeding ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Upper Gastrointestinal Bleeding ◽  
Upper Gastrointestinal

scholarly journals Acute Esophageal Necrosis (AEN) - A Rare Syndrome: Report of a Case in a Patient with an Underlying Malignancy and Review of the Literature

2020 ◽  
pp. 1-3
Author(s):  
Zenzola Víctor ◽  
Barranco Cao Raquel ◽  
Garzón Carlos ◽  
Herrera María ◽  
Molina Mercedes ◽  
...  
Keyword(s):  
Upper Gastrointestinal Bleeding ◽  
Esophageal Mucosa ◽  
Acute Esophageal Necrosis ◽  
Esophageal Necrosis ◽  
Medical Disorder ◽  
Underlying Malignancy ◽  
Underlying Illness ◽  
Acute Necrotizing ◽  
Upper Gastrointestinal ◽  
Syndrome Report

Acute Esophageal Necrosis (AEN) is a rare medical disorder characterized by a diffuse circumferential black esophageal mucosa. The majority of patients present with signs of upper gastrointestinal bleeding. Diagnosis is based on esophagogastroduodenoscopy. Treatment consists of intravenous fluids, proton pomp inhibitors and treatment of the underlying illness. We report a case of acute necrotizing oesophagitis (AEN) with an underlying malignancy.

scholarly journals An Unusual Cause of Acute Upper Gastrointestinal Bleeding: Acute Esophageal Necrosis

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Nikhil R. Kalva ◽  
Madhusudhan R. Tokala ◽  
Sonu Dhillon ◽  
Watcoun-Nchinda Pisoh ◽  
Saqib Walayat ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Clinical Presentation ◽  
Upper Gastrointestinal Bleeding ◽  
Gastroesophageal Junction ◽  
Atherosclerotic Cardiovascular Disease ◽  
Acute Esophageal Necrosis ◽  
Endoscopic Findings ◽  
Esophageal Necrosis ◽  
Black Esophagus ◽  
Upper Gastrointestinal

Acute esophageal necrosis (AEN), also called “black esophagus,” is a condition characterized by circumferential necrosis of the esophagus with universal distal involvement and variable proximal extension with clear demarcation at the gastroesophageal junction. It is an unusual cause of upper gastrointestinal bleeding and is recognized with distinct and striking mucosal findings on endoscopy. The patients are usually older and are critically ill with shared comorbidities, which include atherosclerotic cardiovascular disease, diabetes mellitus, hypertension, chronic renal insufficiency, and malnutrition. Alcoholism and substance abuse could be seen in younger patients. Patients usually have systemic hypotension along with upper abdominal pain in the background of clinical presentation of hematemesis and melena. The endoscopic findings confirm the diagnosis and biopsy is not always necessary unless clinically indicated in atypical presentations. Herein we present two cases with distinct clinical presentation and discuss the endoscopic findings along with a review of the published literature on the management of AEN.

Correction: Acute esophageal necrosis (black esophagus) with active upper gastrointestinal bleeding: What to do?

Endoscopy ◽  
2021 ◽  
Author(s):  
Igor Braga Ribeiro ◽  
Gustavo de Oliveira Luz ◽  
Gabriel Mayo Vieira de Souza ◽  
Mateus Bond Boghossian ◽  
Epifânio Silvino do Monte Junior ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Acute Esophageal Necrosis ◽  
Esophageal Necrosis ◽  
Black Esophagus ◽  
Upper Gastrointestinal
Sign in / Sign up

Export Citation Format

Share Document