Sachar Moniyka, Arguetta Erick, Gurvits Grigoriy E
Department of Medicine, New York University Langone Medical Center, 247 E 28Th Street, New York, NY, 10016, USA.
Division of Gastroenterology, Brown University, Providence, RI, USA.
Dig Dis Sci. 2023 May;68(5):1672-1676. doi: 10.1007/s10620-023-07869-6. Epub 2023 Mar 24.
Acute esophageal necrosis (AEN) in the setting of gastric volvulus is a rare condition with only a handful of cases reported. Volvulus may contribute to AEN by limiting tissue perfusion and promoting massive reflux of gastric contents on compromised esophageal mucosa.
We reviewed 225 original articles, literature reviews, case series, brief reports, case reports, and discuss six total cases of co-occurring esophageal necrosis and gastric volvulus.
We present the first comprehensive analysis of all reported cases in the literature to date and formulate management strategies for the co-occurrence of AEN and volvulus. Management of AEN should be directed at correcting underlying medical conditions, providing hemodynamic support, initiating nil-per-os restriction, and administering high-dose proton pump inhibitor therapy. Surgical intervention is typically reserved for cases of esophageal perforation with mediastinitis and abscess formation.
胃扭转情况下的急性食管坏死（AEN）是一种罕见病症，仅有少数病例报道。扭转可能通过限制组织灌注以及促使胃内容物大量反流至受损的食管黏膜而导致急性食管坏死。
我们查阅了225篇原创文章、文献综述、病例系列、简短报告、病例报告，并讨论了总共6例同时出现食管坏死和胃扭转的病例。
我们对迄今为止文献中所有报道的病例进行了首次全面分析，并制定了急性食管坏死和扭转同时发生的管理策略。急性食管坏死的管理应旨在纠正潜在的医疗状况、提供血流动力学支持、开始禁食限制，并给予高剂量质子泵抑制剂治疗。手术干预通常仅适用于伴有纵隔炎和脓肿形成的食管穿孔病例。
