Pramparo Silvana E, Ruiz Pablo M, Flores Valencia Rogelio, Rodeiro José
Servicio de Clínica Médica, Hospital Regional Río Gallegos.
Medicina (B Aires). 2010;70(6):524-6.
Acute esophageal necrosis (AEN), also designated black esophagus, is a rare disorder that is poorly described in the medical literature. We present the case of an 80 years old man, with upper gastrointestinal bleeding who developed a black esophagus after hypotensive episodes. Necrosis was confirmed histologically. Hematemesis and melena are present in more than 70% of the cases. Endoscopic findings show black discoloration of the distal esophagus with proximal extension ending sharply at the gastroesophageal junction. Diagnosis is reached endoscopically with histological support. Mortality is high (up to 50%) even though related to the patient's underlying condition. Finally, we may say that to keep in mind the possibility of AEN is a key factor in its diagnosis, particularly in older patients with associated morbidity and evidence of upper gastrointestinal bleeding. In the present report we describe the clinical, endoscopic and histophatological characteristics of a patient with a diagnosis of AEN.
急性食管坏死(AEN),也称为黑色食管,是一种罕见的疾病,医学文献中对此描述甚少。我们报告一例80岁男性病例,该患者因上消化道出血在低血压发作后出现黑色食管。组织学检查证实为坏死。超过70%的病例出现呕血和黑便。内镜检查结果显示食管远端呈黑色变色,近端延伸至胃食管交界处时突然终止。在内镜检查并获得组织学支持后作出诊断。尽管死亡率与患者的基础疾病有关,但死亡率仍然很高(高达50%)。最后,我们可以说,牢记急性食管坏死的可能性是其诊断的关键因素,特别是对于伴有相关疾病和有上消化道出血证据的老年患者。在本报告中,我们描述了一例诊断为急性食管坏死患者的临床、内镜和组织病理学特征。