Scientific letter
Black oesophagus (acute oesophageal necrosis)
Esófago negro (necrosis aguda esofágica)
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"<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "Gonzalo" "apellidos" => "Hijos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 6 => array:3 [ "nombre" => "Sandra" "apellidos" => "García" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 7 => array:3 [ "nombre" => "Raúl" "apellidos" => "Velamazán" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 8 => array:3 [ "nombre" => "José Manuel" "apellidos" => "Blas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 9 => array:3 [ "nombre" => "Ángel" "apellidos" => "Ferrández" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Aparato Digestivo, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet, Zaragoza, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Esófago negro (necrosis aguda esofágica)" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1549 "Ancho" => 3167 "Tamanyo" => 349114 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Endoscopic findings. (A) Mucosa of the medial oesophagus with blackish discolouration and longitudinal ulcerations. (B and C) Abrupt stop at the gastro-oesophageal junction. (D) Necrosis of the second duodenal segment. (E) Obstructive oesophageal stenosis shown on follow-up gastroscopy. (F) Course of oesophageal stenosis following several sessions of dilatation.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We present the case of an 85-year-old female patient with a history of hypertension, diabetes mellitus, dyslipidaemia and pulmonary embolism. She had been experiencing epigastric pain for the past 3 days associated with nausea and vomiting. Laboratory testing found high acute-phase reactants. A plain X-ray and an abdominal CT scan were also performed and showed gastric dilatation and signs suggestive of chronic pancreatitis. It was decided to extend the study by performing a gastroscopy. This revealed an oesophageal surface with blackish discolouration from the proximal oesophagus (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A) that did not detach with lavage, suggestive of a necrotic process, associated with longitudinal ulcerations and an abrupt change in the oesophageal–gastric transition (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B and C), with no evidence of lesions in the stomach. Multiple ulcers alternating with areas of necrosis were also present in the second duodenal segment (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>D). Biopsies taken confirmed necrotic ischaemic changes in the duodenal mucosa.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Given the endoscopic findings, another CT scan was performed, this time a thoraco-abdominal CT scan, which ruled out complications. Treatment was started with total parenteral nutrition and intravenous omeprazole as well as empirical antifungal and antibiotic coverage with meropenem and fluconazole. The patient's subsequent clinical course was satisfactory; therefore, following conservative management for 15 days, another gastroscopy was performed. It showed an oesophageal mucosa with a whitish appearance, covered in fibrin, with a decrease in its calibre towards the cardia, which exhibited obstructive stenosis (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>E). Several sessions of endoscopic dilatation were performed successfully (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>F).</p><p id="par0015" class="elsevierStylePara elsevierViewall">Acute oesophageal necrosis is an uncommon entity reported for the first time in 1990 by Goldenberg et al.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> It primarily affects males in their fifties,<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> and its prevalence and incidence are low, though its exact incidence and prevalence cannot be known, as it is an under-diagnosed condition.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> Its aetiology is multifactorial, and primarily secondary to ischaemic damage in patients with cardiovascular risk factors and in a context of haemodynamic compromise or low output, including sepsis, heart failure, acute haemorrhage and systemic inflammatory response. Circulation from branches of the coeliac trunk indicates that there may be concomitant lesions in the distal oesophagus and duodenum. Other factors that influence the development of lesions are abnormalities in oesophageal defensive mechanisms and massive passage of gastric contents towards the oesophagus.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> In the case reported, a potential flare-up of chronic pancreatitis in a patient of advanced age with cardiovascular risk factors is put forward as a possible trigger of oesophageal and duodenal lesions.</p><p id="par0020" class="elsevierStylePara elsevierViewall">In up to 90% of reported cases the initial sign is upper gastrointestinal bleeding,<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> though other symptoms such as abdominal pain and vomiting may appear or the patient may be asymptomatic. The condition is diagnosed by gastroscopy. It is not strictly necessary to perform biopsies, as the lesions are very distinctive and include a blackish oesophageal mucosa, which essentially affects the distal third (the least vascularised area), with an abrupt stop at the gastro-oesophageal junction.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> Concomitant duodenal involvement in the form of necrosis, ulcers and/or inflammatory changes may appear in up to 50% of cases.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> It is important to perform a differential diagnosis with other conditions, especially if there is isolated involvement of the medial or proximal oesophagus; it is necessary to rule out infectious disease, melanoma, <span class="elsevierStyleItalic">acanthosis nigricans</span> and ingestion of caustic substances.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> In the case presented, the patient denied having ingested caustic substances, and viral serology was performed and came back negative.</p><p id="par0025" class="elsevierStylePara elsevierViewall">In general, management is conservative and includes management of underlying disease and supportive measures such as fluid therapy, total parenteral nutrition, treatment with proton-pump inhibitors at high doses and sucralfate.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> The use of empirical antibiotic treatment is controversial and is recommended if there is evidence of bacterial infection or suspected perforation. In this case, conservative management was pursued after complications were ruled out.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Overall mortality may be as high as 32%<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> and is primarily associated with comorbidities as well as the seriousness of the underlying disease. The most feared complication is perforation. This appears in less than 7% of cases and usually requires a surgical approach. Treatment with an oesophageal <span class="elsevierStyleItalic">stent</span> may be considered in select cases.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> The most common complications include the development of stenosis (in 25% of cases)<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a>; this can generally be managed with endoscopic dilatation.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Laredo V, Navarro M, Alfaro E, Cañamares P, Abad D, Hijos G, et al. Esófago negro (necrosis aguda esofágica). Gastroenterol Hepatol. 2020;43:201–202.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1549 "Ancho" => 3167 "Tamanyo" => 349114 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Endoscopic findings. (A) Mucosa of the medial oesophagus with blackish discolouration and longitudinal ulcerations. (B and C) Abrupt stop at the gastro-oesophageal junction. (D) Necrosis of the second duodenal segment. (E) Obstructive oesophageal stenosis shown on follow-up gastroscopy. (F) Course of oesophageal stenosis following several sessions of dilatation.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acute necrotizing esophagitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S.P. Goldenberg" 1 => "S.L. Wain" 2 => "P. Marignani" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/0016-5085(90)90844-q" "Revista" => array:6 [ "tituloSerie" => "Gastroenterology" "fecha" => "1990" "volumen" => "98" "paginaInicial" => "493" "paginaFinal" => "496" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2295407" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acute esophageal necrosis: a rare syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "G.E. Gurvits" 1 => "A. Shapsis" 2 => "N. Lau" 3 => "N. Gualtieri" 4 => "J.G. Robilotti" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00535-006-1974-z" "Revista" => array:6 [ "tituloSerie" => "J Gastroenterol" "fecha" => "2007" "volumen" => "42" "paginaInicial" => "29" "paginaFinal" => "38" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17322991" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Black esophagus: acute esophageal necrosis syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "G.E. Gurvits" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3748/wjg.v16.i26.3219" "Revista" => array:6 [ "tituloSerie" => "World J Gastroenterol" "fecha" => "2010" "volumen" => "16" "paginaInicial" => "3219" "paginaFinal" => "3225" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20614476" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Black esophagus: a case series and literature review of acute esophageal necrosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C.R. Lamers" 1 => "W.G.N. Mares" 2 => "D.J. Bac" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1080/00365521.2018.1513064" "Revista" => array:6 [ "tituloSerie" => "Scand J Gastroenterol" "fecha" => "2018" "volumen" => "53" "paginaInicial" => "1421" "paginaFinal" => "1424" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30353761" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Black esophagus: new insights and multicenter international experience in 2014" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G.E. Gurvits" 1 => "K. Cherian" 2 => "M.N. Shami" 3 => "R. Korabathina" 4 => "E.M. El-Nader" 5 => "K. Rayapudi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10620-014-3382-1" "Revista" => array:6 [ "tituloSerie" => "Dig Dis Sci" "fecha" => "2015" "volumen" => "60" "paginaInicial" => "444" "paginaFinal" => "453" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25297468" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/24443824/0000004300000004/v1_202004200614/S2444382420300377/v1_202004200614/en/main.assets" "Apartado" => array:4 [ "identificador" => "77930" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Scientific letter" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/24443824/0000004300000004/v1_202004200614/S2444382420300377/v1_202004200614/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444382420300377?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 8 | 1 | 9 |
| 2024 October | 11 | 5 | 16 |
| 2024 September | 32 | 10 | 42 |
| 2024 August | 26 | 3 | 29 |
| 2024 July | 15 | 2 | 17 |
| 2024 June | 23 | 3 | 26 |
| 2024 May | 13 | 5 | 18 |
| 2024 April | 21 | 19 | 40 |
| 2024 March | 43 | 9 | 52 |
| 2024 February | 14 | 3 | 17 |
| 2024 January | 18 | 4 | 22 |
| 2023 December | 23 | 3 | 26 |
| 2023 November | 42 | 6 | 48 |
| 2023 October | 19 | 10 | 29 |
| 2023 September | 10 | 1 | 11 |
| 2023 August | 25 | 6 | 31 |
| 2023 July | 19 | 5 | 24 |
| 2023 June | 17 | 2 | 19 |
| 2023 May | 45 | 6 | 51 |
| 2023 April | 48 | 4 | 52 |
| 2023 March | 23 | 1 | 24 |
| 2023 February | 27 | 4 | 31 |
| 2023 January | 25 | 4 | 29 |
| 2022 December | 34 | 2 | 36 |
| 2022 November | 46 | 5 | 51 |
| 2022 October | 59 | 10 | 69 |
| 2022 September | 19 | 8 | 27 |
| 2022 August | 9 | 6 | 15 |
| 2022 July | 7 | 8 | 15 |
| 2022 June | 8 | 10 | 18 |
| 2022 May | 15 | 10 | 25 |
| 2022 April | 17 | 11 | 28 |
| 2022 January | 1 | 0 | 1 |
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