Maubert A, Frey S, Rahili A, Filippi J, Benizri E
Service de Chirurgie Générale et Cancérologie Digestive, Centre Hospitalier Universitaire de Nice, Hôpital de l'Archet 2, France.
Service de Chirurgie Générale et Cancérologie Digestive, Centre Hospitalier Universitaire de Nice, Hôpital de l'Archet 2, France.
Int J Surg Case Rep. 2019;61:188-190. doi: 10.1016/j.ijscr.2019.07.041. Epub 2019 Jul 22.
Acute Esophageal Necrosis Syndrome (AENS) is a rare and unknown clinical entity, defined as a diffuse circumferential black-appearing friable esophageal mucosa going from the distal esophageal mucosa to the gastroesophageal (GE) junction. Esophagogastroduodenoscopy (EGD) remains the gold standard in making diagnosis.
We report here the case of a 45-year-old man with necrosis of the esophagus treated conservatively. Regression of the lesion but persistence of ulcerations were seen on the endoscopic follow-up. Distal esophageal stenosis was then diagnosed and treated by endoscopic dilation.
Diagnosis of AENS must be considered when an old patient, with multiple comorbidities, presents an upper digestive hemorrhage. Upper endoscopy is mandatory. Treatment is in most of the cases conservative. Esophageal stenosis is a frequent complication.
Although AENS is a rare clinical entity, it should not be dismissed by doctors, avoiding useless surgical management. This pathology remains nevertheless associated with a considerable mortality rate.
急性食管坏死综合征（AENS）是一种罕见且尚不明确的临床病症，定义为从食管远端黏膜至胃食管（GE）交界处出现的弥漫性环形黑色易碎食管黏膜。食管胃十二指肠镜检查（EGD）仍是诊断的金标准。
我们在此报告一例45岁食管坏死男性患者，接受了保守治疗。在内镜随访中可见病变消退但溃疡持续存在。随后诊断为食管远端狭窄并通过内镜扩张进行治疗。
当老年患者伴有多种合并症出现上消化道出血时，必须考虑AENS的诊断。上消化道内镜检查是必不可少的。大多数情况下治疗是保守的。食管狭窄是常见的并发症。
尽管AENS是一种罕见的临床病症，但医生不应忽视它，避免进行不必要的手术治疗。然而，这种病症的死亡率仍然相当高。
