Black Esophagus: New Insights and Multicenter International Experience in 2014

摘要: Black esophagus or acute esophageal necrosis (AEN) is a striking medical condition characterized by circumferential black appearing mucosa affecting various lengths of the organ with nearly universal involvement distal and abrupt transition at gastroesophageal junction. This syndrome gaining acceptance as an important cause upper gastrointestinal hemorrhage in hospitalized patients. To better describe clinical features, risk factors, associated conditions, etiology, treatment, complications, outcome patients AEN centers across globe. We analyze this first international multicenter series eight who presented AEN. Clinical characteristics were recorded for each case treating physicians, data retrospectively analyzed compared. more common geriatric males characteristically (88 %) presents signs hemorrhage. Risk factors include alcohol abuse, hypertension, diabetes mellitus, dyslipidemia, chronic kidney disease, malnourishment, vascular disease. Hypoalbuminemia was universal, while anemia, renal insufficiency, hyperglycemia seen 90 % Endoscopically, proximal extension sharp demarcation GE junction all Duodenal pathology 50 % cases. Causes largely multifactorial affected combination ischemic insult, compromised mucosal defenses, corrosive reflux injury gastric contents. Treatment acid suppression correction underlying conditions implemented Esophageal stricture formation 25 % concurrent duodenal pathology. Mortality 12.5 % unrelated to endoscopic presentation clinically individual multiple co-morbidities. Structured conservative management etiology essential improved prognosis. Associated on endoscopy reflection degree initial insult predictor potential development. Proximal may be related hyperglycemia. Increased awareness will lead early recognition proper treatment.