Acute Esophageal Necrosis Syndrome (Black Esophagus): A Case Report of Rare Presentation

Division

Far West

Hospital

MountainView Hospital

Document Type

Case Report

Publication Date

4-19-2022

Keywords

clinical gastroenterology, end of life and hospice care, medical intensive care unit (micu), hepatocellular carcinoma (hcc), acute esophageal necrosis (aen)

Disciplines

Digestive System Diseases | Internal Medicine | Neoplasms

Abstract

Acute esophageal necrosis (AEN) is a rare clinical finding due to multifocal factors consisting of an ischemic insult to the esophagus, corrosive injury from gastric content, and diminished mucosal defense. It is also referred to as “black esophagus” or acute necrotizing esophagitis. The clinical presentation mainly consists of upper gastrointestinal bleed and abdominal pain. Associated symptoms include nausea, vomiting, and dysphagia. AEN can be diagnosed by esophagogastroduodenoscopy (EGD) with findings of diffuse circumferential black pigmentation in the distal esophagus that classically extends to the gastroesophageal junction. A diagnostic biopsy is not required but recommended. Treatment of AEN is conservative management to maintain hemodynamic stability and treat coexisting medical conditions. Herein, we present the case of a 78-year-old male who initially presented with hematemesis and abdominal discomfort of five-day duration and was subsequently found to have AEN.

Publisher or Conference

Cureus

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