scholarly journals “Black Esophagus” or Gurvits Syndrome: A Rare Complication of Diabetic Ketoacidosis

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Vivek Choksi ◽  
Kairavee Dave ◽  
Rulz Cantave ◽  
Sameer Shaharyar ◽  
Jeevan Joseph ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Diabetic Ketoacidosis ◽  
High Mortality ◽  
Rare Complication ◽  
Gastroesophageal Junction ◽  
Distal Esophagus ◽  
Esophageal Mucosa ◽  
Acute Esophageal Necrosis ◽  
Black Esophagus ◽  
Sixth Decade

Acute esophageal necrosis (AEN) also known as “black esophagus” or necrotizing esophagitis is a rare syndrome characterized by a striking diffuse patchy or circumferential black appearance of the esophageal mucosa that preferentially affects the distal esophagus and terminates at the gastroesophageal junction. Only 88 patients over a span of 40 years have received this diagnosis, and the prevalence of this disease ranges from 0.001 to 0.2% of cases in literature. It more commonly affects men (4 : 1 ratio) in the sixth decade of life. It is associated with a high mortality rate, approaching 32%. We report a case of AEN presenting in the setting of diabetic ketoacidosis (DKA), affecting both the proximal and distal esophagus.

scholarly journals Black Esophagus: A Rare Case of Acute Esophageal Necrosis Induced by Diabetic Ketoacidosis in a Young Adult Female

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Zachary Field ◽  
Jacqueline Kropf ◽  
Meghan Lytle ◽  
Giselle Castaneira ◽  
Mario Madruga ◽  
...  
Keyword(s):  
Diabetic Ketoacidosis ◽  
Outlet Obstruction ◽  
Distal Esophagus ◽  
Fluid Loss ◽  
Acute Esophageal Necrosis ◽  
Clinical Disorder ◽  
Esophageal Necrosis ◽  
Black Esophagus ◽  
Poor Nutritional Status ◽  
Older Males

Background. Acute esophageal necrosis is an uncommon clinical disorder diagnosed on endoscopy as a black esophagus. It has a multifactorial etiology that probably represents a combination of poor nutritional status, gastric outlet obstruction, and ischemia secondary to hypoperfusion of the distal esophagus. It typically occurs in older males with comorbidities. Case. A 37-year-old woman presented with diabetic ketoacidosis and hematemesis. At esophagogastroduodenoscopy acute esophageal necrosis was diagnosed. The treatment included fluid and electrolyte management, insulin, and a proton pump inhibitor. She improved and left the hospital on day 3. Conclusion. Diabetic ketoacidosis can result in a profound osmotic diuresis, fluid loss, and hypoperfusion of the distal esophagus. This condition can then lead to ischemic injury and acute esophageal necrosis. Awareness of the possibility of its presence in young women with hematemesis and poorly controlled diabetes is important since early identification with esophagogastroduodenoscopy is necessary to prevent serious postnecrotic complications.

Acute Esophageal Necrosis (Black Esophagus): An Autopsy Case Series

2021 ◽  
Vol 11 (3) ◽  
pp. 115-125
Author(s):  
Lauren R. Crowson-Hindman ◽  
Keenen Smith ◽  
Angelina Phillips
Keyword(s):  
Gastroesophageal Junction ◽  
Case Series ◽  
Background Information ◽  
Unknown Etiology ◽  
Pathologic Finding ◽  
Esophageal Mucosa ◽  
Acute Esophageal Necrosis ◽  
Esophageal Necrosis ◽  
Black Esophagus ◽  
Acute Necrotizing

Introduction: Acute esophageal necrosis (AEN), also known as black esophagus and acute necrotizing esophagitis, is a rare pathologic finding of unknown etiology. It was first characterized as diffuse, circumferential black discoloration of the esophageal mucosa that affects predominantly the distal esophagus with sharp transition to normal-appearing mucosa at the gastroesophageal junction. Case frequency of AEN remains low and mainly found incidentally, with up to 0.2% in autopsy and endoscopy studies. Men are 4 times more commonly affected and overall mortality is approximately 32%. Methods: Black esophagus was incidentally found during ten forensic autopsy cases. Complete autopsies with photographs, histological examination, and toxicological analysis were performed. Case background information was reviewed. A review of literature was done, with research criteria including previous case reports, diagnosis, and autopsy, endoscopic, and microscopic findings of AEN. Results: Nine of ten deceased were male, with an age range of 26 to 67 years old. The most common preexisting pathological condition was chronic alcohol consumption, seen in six of ten cases, and in eight cases, the death occurred suddenly at home. “Classic” black esophagus was only seen in four cases. Upper gastrointestinal hemorrhage due to acute necrotizing esophagitis was established as the immediate cause of death in six of ten cases. Discussion: This case series demonstrates ten cases of AEN with variation in appearance, yet diagnosis supported by histology, ancillary testing, and case information. The case frequency was higher than previously reported, 0.7%, suggesting that the prevalence of AEN may be underestimated, especially in forensic death investigations.

scholarly journals Black Esophagus in the Setting of Diabetic Ketoacidosis: A Rare Finding from Our Institution

2019 ◽  
Vol 13 (3) ◽  
pp. 475-480
Author(s):  
Sara Ghoneim ◽  
Aun Shah ◽  
Shaman Dalal ◽  
Marc Landsman ◽  
Annette Kyprianou
Keyword(s):  
Diabetic Ketoacidosis ◽  
Case Series ◽  
Acid Reflux ◽  
Esophageal Mucosa ◽  
Upper Endoscopy ◽  
Acute Esophageal Necrosis ◽  
Rare Finding ◽  
Black Esophagus ◽  
Autopsy Series ◽  
Black Discoloration

Acute esophageal necrosis (AEN) is defined as necrosis of the esophageal mucosa seen as diffuse black discoloration of the distal esophagus on an upper endoscopy. The prevalence of the disease is rare and reported to be up to 0.2% in autopsy series. The etiology of the disease is thought to be multifactorial and due to ischemic insults to the esophagus with gastric acid reflux further damaging the vulnerable mucosa. Patients are often critically ill or with significant comorbidities. Here, we present a case series of 3 patients with AEN induced by diabetic ketoacidosis.

scholarly journals Black Esophagus in the Setting of Alcohol Abuse after External Beam Radiation

2020 ◽  
Vol 14 (2) ◽  
pp. 443-447
Author(s):  
Smit S. Deliwala ◽  
Harini Lakshman ◽  
Douglas D. Congdon ◽  
Mamoon M. Elbedawi ◽  
Ghassan Bachuwa ◽  
...  
Keyword(s):  
Unusual Case ◽  
Gastroesophageal Junction ◽  
The Elderly ◽  
External Beam Radiation ◽  
Esophageal Mucosa ◽  
Beam Radiation ◽  
Acute Esophageal Necrosis ◽  
Clinical Disorder ◽  
Black Esophagus ◽  
Upper Gastrointestinal

Acute esophageal necrosis (AEN), black esophagus, or Gurvits syndrome is a rare clinical disorder characterized by a striking endoscopic appearance of necrotic esophageal mucosa, universally affecting the distal esophagus and ending abruptly at the gastroesophageal junction. It has been gaining traction as a demonstrable cause of upper gastrointestinal bleeding in the 21st century. Its pathophysiology is multifactorial affecting men and the elderly disproportionally, with a mortality rate nearing 36%. AEN has been associated with numerous conditions in the past, and we aim to present an unusual case of AEN on the setting of chronic alcohol use.

scholarly journals Acute esophageal necrosis: A rare case of upper gastrointestinal bleeding from diabetic ketoacidosis

2020 ◽  
Vol 10 (2) ◽  
Author(s):  
Dustin J. Uhlenhopp ◽  
Gregory Pagnotta ◽  
Tagore Sunkara
Keyword(s):  
Diabetic Ketoacidosis ◽  
Gastroesophageal Junction ◽  
Stable Condition ◽  
Rare Condition ◽  
Critically Ill Patient ◽  
Acute Esophageal Necrosis ◽  
Esophageal Necrosis ◽  
Black Esophagus ◽  
Acute Necrotizing ◽  
Upper Gastrointestinal

Acute esophageal necrosis, also known as black esophagus or acute necrotizing esophagitis is a rare condition with roughly 154 cases reported in the literature. This condition is classically diagnosed on its endoscopic findings of a circumferentially black esophagus that abruptly ends at the gastroesophageal junction and transitions to normal gastric mucosa. When present, acute esophageal necrosis potentially signifies a poor prognosis with an overall mortality up to 36%. This case report describes a critically ill patient with multiple comorbidities that was found to have acute esophageal necrosis the entire length of the esophagus secondary to ischemia/hypoperfusion that was caused by diabetic ketoacidosis. The patient had a prolonged hospitalization but was ultimately discharged in stable condition. We also review the literature of this rare esophageal condition.

scholarly journals Acute Esophageal Necrosis and Low-Flow State

2007 ◽  
Vol 21 (4) ◽  
pp. 245-247 ◽  
Author(s):  
Ahmad Burtally ◽  
Philippe Gregoire
Keyword(s):  
Gastroesophageal Junction ◽  
Low Flow ◽  
Quebec City ◽  
Flow State ◽  
Present Case Report ◽  
Acute Esophageal Necrosis ◽  
Esophageal Necrosis ◽  
Black Esophagus ◽  
Proximal Extension ◽  
Clinical Conditions

Acute esophageal necrosis (AEN), also called black esophagus, is quite exceptional. Endoscopic findings show circumferential black discolouration of the esophagus with or without exudates. The etiology of AEN is presently unknown and is assumed to be multifactorial. Distal esophageal involvement with proximal extension ending sharply at the gastroesophageal junction is the most common presentation. The present case report describes the clinical and endoscopic evolution of black esophagus observed in a patient with significant peripheral vascular disease, who was presented to the intensive care unit at the Hopital Saint-Francois d’Assise (Quebec City, Quebec). Through an extensive review of the literature, common underlying clinical conditions of patients diagnosed with AEN have been identified.

Lateral sinus thrombosis following myringoplasty: a rare complication

2012 ◽  
Vol 127 (S1) ◽  
pp. S39-S41 ◽  
Author(s):  
G Sim ◽  
F Lannigan
Keyword(s):  
Case Report ◽  
Mortality Rate ◽  
Otitis Media ◽  
High Mortality ◽  
Sinus Thrombosis ◽  
Rare Complication ◽  
Lateral Sinus ◽  
Lateral Sinus Thrombosis ◽  
Life Threatening ◽  
Life Threatening Complication

AbstractObjective:We report lateral sinus thrombosis occurring as a rare complication following a routine and uneventful otological procedure.Case report:Lateral sinus thrombosis is a rare but known complication of otitis media. It has not been documented as a complication of routine otological surgery. We present a case of this rare complication following a myringoplasty. We also discuss the presentation, investigation and treatment of lateral sinus thrombosis. It is essential to be able to recognise and treat this rare complication early, due to its high mortality rate.Conclusion:Lateral sinus thrombosis is a rare but potentially life-threatening complication. It is therefore essential for clinicians to be able to recognise and treat this condition early.

scholarly journals Acute Esophageal Necrosis in a Septic Patient with a History of Cardiovascular Disease

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Michael Coles ◽  
Victoria Madray ◽  
Pearl Uy
Keyword(s):  
Cardiovascular Disease ◽  
Gallstone Pancreatitis ◽  
Esophageal Mucosa ◽  
Upper Endoscopy ◽  
Endoscopic Retrograde ◽  
Acute Esophageal Necrosis ◽  
Esophageal Necrosis ◽  
Black Esophagus ◽  
History Of ◽  
Gi Bleed

Acute esophageal necrosis (AEN), or colloquially named “black esophagus,” is a rare clinical condition often associated with ischemic injury to the esophagus secondary to splanchnic vasoconstriction during hypotensive episodes. We present a case of a 78-year-old man with extensive cardiovascular disease who was initially admitted for gallstone pancreatitis and possible cholangitis. His hospital course was complicated by possible sepsis secondary to aspiration pneumonia and hematemesis secondary to acute ischemic esophageal necrosis as noted on upper endoscopy. Interestingly, the patient only had a transient episode of hypotension (approximately 35 minutes) not requiring vasopressor support, which improved with fluid resuscitation, and endoscopic retrograde cholangiopancreatography (ERCP) done 3 days prior showed normal esophageal mucosa. Clinicians should be aware of the possibility of acute esophageal necrosis as a potential etiology of gastrointestinal (GI) bleed in patients with cardiovascular disease and sepsis.

Necrosis esofágica aguda en pacientes post trasplante hepático. Un túnel oscuro desde el hígado al esófago

2021 ◽  
Vol 51 (1) ◽  
Author(s):  
Gustavo Cernadas ◽  
Vanina Forestier ◽  
Karen Stave Salgado ◽  
Paola Coisson ◽  
Marylin Castilla ◽  
...  
Keyword(s):  
Gastroesophageal Junction ◽  
Esophageal Mucosa ◽  
Rare Entity ◽  
Proper Treatment ◽  
Acute Esophageal Necrosis ◽  
Support Measures ◽  
Vascular Compromise ◽  
Underlying Illness ◽  
Circumferential Distribution ◽  
Clinical Conditions

Acute esophageal necrosis is a rare entity endoscopically described as a black appearance of esophageal mucosa, generally of circumferential distribution that extends proximally from the gastroesophageal junction, and affects a variable length of this organ. It has a multifactorial etiology that includes a combination of ischemic mucosal esophageal vascular compromise associated with gastroesophageal reflux in patients with multiple comorbidities. Clinical management focuses on general support measures and treatment of the underlying illness and comorbidities. Although this pathology usually tends to a restitution-ad-integrum in 7-10 days, these patients have a high mortality rate more related to their clinical conditions and not due to this entity itself. Therefore, early diagnosis is crucial to initiate proper treatment. We present two cases of AEN in patients who underwent orthotopic liver transplantation.

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