Acute esophageal necrosis

Source: Wikipedia, the free encyclopedia.
Acute esophageal necrosis
Other namesGurvits syndrome, black esophagus, acute necrotizing esophagitis,
Upper endoscopy
(EGD)
TreatmentVaries
DeathsMortality rate 30–50%

Acute esophageal necrosis (AEN), black esophagus, or Gurvits syndrome is a rare

mucosa.[citation needed] The disorder is extremely rare, as only 89 patients over a span of 40 years have received this diagnosis.[2] Specific study of the disorder's mortality rate is mentioned at 31.8%,[2] but new research suggests mortality rates vary from 30–50%.[3][4] The exact triggering mechanism for this disorder is still unknown, but is likely multifactorial.[2]

Signs and symptoms

AEN has never been recorded as a one symptom disorder, but instead present by multiple symptoms.

blood in vomiting. Upper gastrointestinal bleeding then is reported, and is very commonly represented in elderly patients.[3] Black or bloody stools and hematemesis account for over three quarters of the case presentations. Abdominal pain, nausea, vomiting, and unstable vital signs are common. A cardiovascular event (such as a heart attack) was reported in ten percent of the total known cases.[2]

Risk factors

Modifiable

Having

Kidney failure, and malnutrition are other major risk factors.[2][6]

Nonmodifiable

Lesser or unknown of effect

Diagnosis

Acute esophageal necrosis can only be diagnosed by an upper gastrointestinal endoscopy.[2][5][7] It is usually preceded by haemodynamic stress, which can have a variety of etiologies.[8]

Treatment

Currently, there is no direct treatment for AEN.

proton pump inhibitor.[6] Sucralfate was used as an option. Parenteral nutrition greatly increased chance of recovery. An esophagectomy can be issued if the disorder is severe enough.[6]

Prognosis

The prognosis for acute esophageal necrosis is generally poor, as the condition is associated with a high risk of mortality (up to 32%).[9] Most mortality is attributed to the underlying cause; mortality specifically caused by AEN is about 6 percent.[9]

Society and culture

Acute esophageal necrosis made an appearance on an

alcohol use disorder
.

History

Acute esophageal necrosis was first described by Goldenberg et al. in 1990.[2][6] Cases have emerged since 1960, but have never been described as the common names for AEN. Due to its rarity, only 88 cases have been pronounced AEN, but most likely there are many more. Gurvits et al. describes AEN as "poorly described in medical literature".[2] Abdullah et al. published the first-ever systemic review on acute esophageal necrosis and reviewed around 154 patients reported in the literature at the time of publishing.[10]

References

External links