Rahim Farrah, Kapliyil Subramanian Sruthi, Larson Scott
Gastroenterology, University of Texas Health Science Center at Houston McGovern Medical School, Houston, USA.
Cureus. 2022 Feb 15;14(2):e22241. doi: 10.7759/cureus.22241. eCollection 2022 Feb.
Acute esophageal necrosis (AEN) is a rare endoscopic finding associated with ischemic compromise of the distal esophagus. This finding can be seen in critically ill patients with COVID-19 infection. We present a case of a COVID-19-vaccinated elderly male with multiple comorbidities and active COVID-19 pneumonia admitted to the intensive care unit with septic shock and acute hypoxemic respiratory failure. The patient developed melena, and esophagogastroduodenoscopy (EGD) was performed, which showed necrosis of the lower esophagus suggestive of AEN. AEN has been associated with high mortality and should be considered when evaluating upper gastrointestinal bleed in a critically ill patient. This case describes the first report of isolated AEN in a patient fully vaccinated against COVID-19 presenting with a severe complicated COVID-19 infection.
急性食管坏死（AEN）是一种罕见的内镜检查发现，与食管远端的缺血性损害有关。在感染新冠病毒疾病（COVID-19）的危重症患者中可见此表现。我们报告一例接种过COVID-19疫苗的老年男性病例，该患者有多种合并症且患有活动性COVID-19肺炎，因感染性休克和急性低氧性呼吸衰竭入住重症监护病房。患者出现黑便，遂进行了食管胃十二指肠镜检查（EGD），结果显示食管下段坏死，提示为AEN。AEN与高死亡率相关，在评估危重症患者的上消化道出血时应予以考虑。本病例描述了首例在接种了COVID-19疫苗且出现严重复杂COVID-19感染的患者中孤立性AEN 的报告。
