Acute Esophageal Necrosis: A Case Series

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Acute esophageal necrosis, or «black esophagus,» is a rare, acute disease characterized by an isolated esophageal mucosa lesion with signs of upper gastrointestinal bleeding (UGB), in combination with severe metabolic disorders. Endoscopy is the «gold standard» diagnostic test. We presented five cases of acute esophageal necrosis diagnosed by upper endoscopy with a UGB at admission. Endoscopy revealed acute necrosis of the esophageal mucosa with no changes in the gastroesophageal junction. Erosive and ulcerative lesions in the stomach and duodenum were diagnosed in all patients. Four patients had severe comorbidities: arterial hypertension, diabetes, and ischemic heart disease. Alcohol abuse occurred in 80% of cases. Patients were treated for both the acute esophageal necrosis and comorbidities, including high doses of proton pump inhibitors, with good effect in three cases. Two patients died due to the progression of multiple organ failures. Acute esophageal necrosis should be included in the differential diagnosis of patients admitted to the hospital with odynophagia and UGB.

Keywords:

acute esophageal necrosis

acute necrotizing esophagitis

black esophagus

endoscopy

gastrointestinal hemorrhage

Authors:

Drobayzgin E.A.

Novosibirsk State Medical University;
Novosibirsk State Regional Clinical Hospital;
Meshalkin National Medical Research Center

ORCID: 0000-0002-3690-1316

Oladko M.R.

Novosibirsk State Regional Clinical Hospital

Chikinev Yu.V.

Novosibirsk State Medical University;
Novosibirsk State Regional Clinical Hospital

ORCID: 0000-0002-6795-6678

Abdrakhmanov S.V.

Novosibirsk State Regional Clinical Hospital

Received:

27.06.2022

Accepted:

13.11.2022

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