title: An Unusual Cause of Acute Upper Gastrointestinal Bleeding: Acute Esophageal Necrosis.
abstract: Acute esophageal necrosis (AEN), also called "black esophagus," is a condition characterized by circumferential necrosis of the esophagus with universal distal involvement and variable proximal extension with clear demarcation at the gastroesophageal junction. It is an unusual cause of upper gastrointestinal bleeding and is recognized with distinct and striking mucosal findings on endoscopy. The patients are usually older and are critically ill with shared comorbidities, which include atherosclerotic cardiovascular disease, diabetes mellitus, hypertension, chronic renal insufficiency, and malnutrition. Alcoholism and substance abuse could be seen in younger patients. Patients usually have systemic hypotension along with upper abdominal pain in the background of clinical presentation of hematemesis and melena. The endoscopic findings confirm the diagnosis and biopsy is not always necessary unless clinically indicated in atypical presentations. Herein we present two cases with distinct clinical presentation and discuss the endoscopic findings along with a review of the published literature on the management of AEN.
authors.affiliation: Division of Gastroenterology and Hepatology, University of Illinois College of Medicine at Peoria, IL, USA.
authors.forename: Nikhil R
authors.identifier: 0000-0003-0444-367X
authors.initials: NR
authors.lastname: Kalva
authors.affiliation: Department of Pharmacology and Pathophysiology, St. George's University School of Medicine, St. George's, West Indies, Grenada.
authors.forename: Madhusudhan R
authors.initials: MR
authors.lastname: Tokala
authors.affiliation: Division of Gastroenterology and Hepatology, University of Illinois College of Medicine at Peoria, IL, USA.
authors.forename: Sonu
authors.initials: S
authors.lastname: Dhillon
authors.affiliation: Division of Gastroenterology and Hepatology, University of Illinois College of Medicine at Peoria, IL, USA.
authors.forename: Watcoun-Nchinda
authors.initials: WN
authors.lastname: Pisoh
authors.affiliation: Division of Gastroenterology and Hepatology, University of Illinois College of Medicine at Peoria, IL, USA.
authors.forename: Saqib
authors.initials: S
authors.lastname: Walayat
authors.affiliation: Division of Gastroenterology and Hepatology, University of Illinois College of Medicine at Peoria, IL, USA.
authors.forename: Vishwas
authors.initials: V
authors.lastname: Vanar
authors.affiliation: Division of Gastroenterology and Hepatology, University of Illinois College of Medicine at Peoria, IL, USA.
authors.forename: Srinivas R
authors.initials: SR
authors.lastname: Puli