Hermet A, Lidove O, Grimbert S, Zeller V, Ducroquet F, Ziza J-M
Service de médecine interne et rhumatologie, hôpital de la Croix Saint-Simon, 125, rue d'Avron, 75020 Paris, France.
Service de médecine interne et rhumatologie, hôpital de la Croix Saint-Simon, 125, rue d'Avron, 75020 Paris, France.
Rev Med Interne. 2014 Jun;35(6):393-5. doi: 10.1016/j.revmed.2013.06.006. Epub 2013 Aug 12.
Acute necrosis of the esophagus, frequently referred to as black esophagus is a rare clinical entity.
We here report a case of an acute necrosis of the esophagus secondary to hemodynamic compromise after total hip replacement. Past medical history of our 72-year-old patient was remarkable for coronary heart disease, obstructive arteriopathy of the lower limbs, diabetes mellitus and hypertension. He was referred for hematemesis and epigastric pain one day after the surgical intervention was performed. Gastric endoscopy showed necrosis of the esophagus. Treatment consisted on intravenous proton pump inhibitor, parenteral renutrition, and red blood cell transfusion. Fours days later, endoscopy found complete disappearance of necrosis.
Black esophagus develops in debilitated patients during hypoperfusion and stress. The outcome is usually favourable in the absence of comorbidities.
食管急性坏死，常被称为黑色食管，是一种罕见的临床病症。
我们在此报告一例全髋关节置换术后因血流动力学受损继发食管急性坏死的病例。我们72岁患者的既往病史有冠心病、下肢阻塞性动脉病、糖尿病和高血压。手术干预一天后，他因呕血和上腹部疼痛前来就诊。胃镜检查显示食管坏死。治疗包括静脉注射质子泵抑制剂、肠外营养支持和红细胞输注。四天后，内镜检查发现坏死完全消失。
黑色食管在灌注不足和应激状态下的虚弱患者中发生。在没有合并症的情况下，预后通常良好。
