Acute Esophageal Necrosis: A View in the Dark

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...

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Published inCase reports in gastroenterology Vol. 13; no. 1; pp. 25 - 31
Main Authors Khan, Hafiz, Ahmed, Moiz, Daoud, Magda, Philipose, Jobin, Ahmed, Saba, Deeb, Liliane
Format Journal Article
LanguageEnglish
Published Basel, Switzerland S. Karger AG 01.01.2019
Karger Publishers
Subjects
Alcohol
Cardiovascular disease
Case reports
Case Series
Diabetes
Endoscopy
Esophageal necrosis
Esophagus
Gastroenterology
Gastrointestinal bleeding
Hospitals
Ischemia
Liver cirrhosis
Necrosis
Pain
Pathogenesis
Patients
Surgery
New York
United States > US
Gastrointestinal bleeding
Esophageal necrosis
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Summary: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.
ISSN:1662-0631
1662-0631
DOI:10.1159/000496385