Hafez Mohammad Abdullah1, Waqas Ullah2, Mohamed Abdallah1, Uzma Khan3, Abu Hurairah4, Muslim Atiq1. 1. a Sanford School of Medicine , University of South Dakota , Sioux Falls , SD , USA. 2. b Abington Hospital - Jefferson Health , Abington , PA , USA. 3. c Khyber Teaching Hospital , Peshawar , Pakistan. 4. d Advent Health , Orlando , FL , USA.
Abstract
BACKGROUND: To review all the reported literature on acute esophageal necrosis. RESEARCH METHODS: Databases were searched using the special Medical Subject Heading (MeSH) terms. All the available reported cases of acute esophageal necrosis were analyzed. RESULTS: A total of 154 cases were identified and 130 cases were analyzed. The mean age of presentation was 61 years, and 70% of cases were males. The most common presenting symptoms were hematemesis in 66%, shock in 36%, melena in 33%, abdominal or substernal pain in 28%. The most common comorbidities reported were diabetes in 38%, hypertension in 37%, alcohol abuse in 25%, and chronic kidney disease in 16%. On upper endoscopy, 51% had a distal disease, 36% had pan esophageal, and only 2% had a proximal disease. 84% of patients were treated with IV Proton Pump Inhibitors, 22% received transfusions, 23% got antibiotics for underlying sepsis, 14% also received sucralfate, and 4% required surgery for treatment. The mortality rate was 32%, while perforation was reported in 5% and stricture formation reported in 9% of patients. CONCLUSIONS: Patients with acute esophageal necrosis can have a favorable outcome if treated appropriately.
BACKGROUND: To review all the reported literature on acute esophageal necrosis. RESEARCH METHODS: Databases were searched using the special Medical Subject Heading (MeSH) terms. All the available reported cases of acute esophageal necrosis were analyzed. RESULTS: A total of 154 cases were identified and 130 cases were analyzed. The mean age of presentation was 61 years, and 70% of cases were males. The most common presenting symptoms were hematemesis in 66%, shock in 36%, melena in 33%, abdominal or substernal pain in 28%. The most common comorbidities reported were diabetes in 38%, hypertension in 37%, alcohol abuse in 25%, and chronic kidney disease in 16%. On upper endoscopy, 51% had a distal disease, 36% had pan esophageal, and only 2% had a proximal disease. 84% of patients were treated with IV Proton Pump Inhibitors, 22% received transfusions, 23% got antibiotics for underlying sepsis, 14% also received sucralfate, and 4% required surgery for treatment. The mortality rate was 32%, while perforation was reported in 5% and stricture formation reported in 9% of patients. CONCLUSIONS:Patients with acute esophageal necrosis can have a favorable outcome if treated appropriately.
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