Jaber Fouad, Alsakarneh Saqr, Sripada Sruthi, Gaur Rishabh, Rajab Rawan, Mohamed Islam, Sanders Kimberly, Ghoz Hassan
Internal Medicine, University of Missouri Kansas City, Kansas, USA.
Gastroenterology and Hepatology, University of Missouri Kansas City, Kansas, USA.
Cureus. 2023 Feb 14;15(2):e34989. doi: 10.7759/cureus.34989. eCollection 2023 Feb.
Black esophagus, also called Gurvits syndrome or acute esophageal necrosis (AEN), is a rare, life-threatening condition characterized by necrosis of the esophageal mucosa. We present a 36-year-old man who presented with hematemesis and was admitted for diabetic ketoacidosis (DKA) management. He then had a further episode of hematemesis with hemodynamic instability. The esophagogastroduodenoscopy (EGD) revealed ulcerative, necrotizing, circumferential esophagitis in the middle and distal third of the esophagus. The patient was treated with intravenous fluid resuscitation, proton pump inhibitors, empiric antibiotics, and antifungals. Hematemesis in DKA should raise suspicion for black esophagus. Prompt detection of AEN allows for early management and thus reduces mortality and associated complications such as perforations and strictures.
黑色食管，也称为古尔维茨综合征或急性食管坏死（AEN），是一种罕见的、危及生命的疾病，其特征为食管黏膜坏死。我们报告一名36岁男性，因呕血就诊，因糖尿病酮症酸中毒（DKA）管理入院。随后他再次出现呕血并伴有血流动力学不稳定。食管胃十二指肠镜检查（EGD）显示食管中下段溃疡性、坏死性、环形食管炎。该患者接受了静脉补液复苏、质子泵抑制剂、经验性抗生素和抗真菌药物治疗。DKA患者出现呕血应怀疑黑色食管。及时发现AEN可实现早期管理，从而降低死亡率以及穿孔和狭窄等相关并发症的发生。
