CASE REPORT
Into the dark of the black oesophagus
1
Department of Gastroenterology with Endoscopy Unit, Medical University, Lublin, Poland
These authors had equal contribution to this work
Corresponding author
Anna Rycyk-Bojarzyńska
Department of Gastroenterology with Endoscopy Unit, Medical University, Lublin, Poland
Department of Gastroenterology with Endoscopy Unit, Medical University, Lublin, Poland
KEYWORDS
black oesophagusGurvit’s syndromeacute oesophageal necrosis (AEN)upper gastrointestinal hemorrhagediabetes mellitus (DM)
TOPICS
ABSTRACT
Acute esophageal necrosis (AEN), known as black oesophagus or Gurvit’s syndrome, is an extremely rare clinical syndrome. Patients usually present with life-threatening symptoms of upper gastrointestinal haemorrhage (70–90% of cases), as in this case report. Diagnosis of AEN is confirmed based on oesophagogastroduodenoscopy which reveals diffuse or patchy circumferential black necrotic oesophageal mucosa. The presented patient had some comorbidities, such as poorly controlled diabetes mellitus, secondary to chronic pancreatitis, hypertension, after cholecystectomy, addiction to alcohol and tobacco, and taking a small spoon of baking soda three times a day for a few months because of heartburn. Despite the poor prognosis of AEN, with mortality about 32–35%, most patients present with endoscopic improvement in short time – from 7 days to 1 month. Fortunately, the patient did not to have any complications in the course of AEN, and the treatment was effective.
ABBREVIATIONS
AEN – acute oesophageal necrosis; CMV – cytomegalovirus; CRP – C-reactive protein; DKA – diabetic ketoacidosis; DM – diabetes mellitus; EGD – oesophagogastroduodenoscopy; GFR – glomerular filtration rate; HSV – herpes simplex virus; PPI – proton pomp inhibitor; TPN – total parenteral nutrition
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