Acute esophageal necrosis
Acute esophageal necrosis | |
---|---|
Other names | Gurvits syndrome, black esophagus, acute necrotizing esophagitis, Upper endoscopy (EGD) |
Treatment | Varies |
Deaths | Mortality rate 30–50% |
Acute esophageal necrosis (AEN), black esophagus, or Gurvits syndrome is a rare
Signs and symptoms
AEN has never been recorded as a one symptom disorder, but instead present by multiple symptoms.
Risk factors
Modifiable
Having
Nonmodifiable
- Advanced age (average patient aged 57 years old)[2]
- Male sex (4 to 1 male dominance)[2]
- Cirrhosis[2]
- HIV/AIDS[2]
- Herpes virus[5]
- Atrial fibrilation[2]
- Diabetes (currently the most prevalent out of all conditions in patients)[2]
Lesser or unknown of effect
- Aortic dissection[3]
- Anti-cardiolipin antibodies[3]
- CMV infection[5]
- Hyperglycemia[5]
- Hypothermia[6]
- Ischemia[3]
- Gastric volvulus[3][5]
- Posterior haematoma[3]
- Septic shock[6]
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.
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
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]