Acute esophageal necrosis: "black esophagus".
Acute esophageal necrosis (AEN) is an uncommon event. We report a case of an 84-year-old female with a giant paraesophageal hernia who presented with coffee ground emesis and on esophagogastroduodenoscopy (EGD) demonstrated findings consistent with acute esophageal necrosis and a giant paraesophageal hernia with normal-appearing gastric mucosa. She was managed conservatively with bowel rest, parenteral nutrition, and continuous intravenous proton pump inhibitor (PPI). After significant improvement in the gross appearance of her esophageal mucosa, surgery was performed to reduce her giant paraesophageal hernia. The patient's postoperative course was uneventful, and she was discharged home on postoperative day 6, tolerating a normal diet. The percutaneous endoscopic gastrostomy (PEG) tube was removed in clinic 2 months postoperatively.
Hwang
Joanna
J
Division of Cardiothoracic Surgery and Department of Gastroenterology, University of Wisconsin, Hospital and Clinics, Madison, Wisconsin 53792, USA. j.hwang@hosp.wisc.edu
Weigel
Tracey L
TL
D000208:Acute Disease; D000369:Aged, 80 and over; D016145:Endoscopy, Digestive System; D004947:Esophagus / Q000098:blood supply* / Q000473:pathology; D005260:Female; D006551:Hernia, Hiatal / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007511:Ischemia / Q000150:complications / Q000473:pathology* / Q000628:therapy; D009336:Necrosis