Yadukumar Lekha, Aslam Hunain, Ahmed Khalid, Iskander Peter, Sajid Khadijah, Syed Omar, Aloysius Mark M, Nasr Simin, Khurana Vikas
Internal Medicine, The Wright Center for Graduate Medical Education, Scranton, Pennsylvania.
Family Medicine, The Wright Center for Graduate Medical Education, Scranton, Pennsylvania.
Gastro Hep Adv. 2023 Apr 15;2(6):827-829. doi: 10.1016/j.gastha.2023.04.002. eCollection 2023.
Acute esophageal necrosis is a rare condition; visualization of necrosis on esophagoduodenoscopy can help establish the diagnosis. Due to variations in blood supply, there is a higher propensity for ischemic episodes to occur along the lower esophagus; these can be of particular importance during times of hypotension. Underlying infections and atherosclerosis can further exacerbate blood supply leading to ischemia in these watershed zones. We present a case of a patient with Klebsiella pneumonia who was found to have "coffee-ground" output on nasogastric tube suctioning. Esophagoduodenoscopy was performed, which showed evidence of circumferential esophageal necrosis. Unfortunately, despite antibiotic and vasopressor support, the patient ultimately passed away.
急性食管坏死是一种罕见疾病；食管十二指肠镜检查发现坏死有助于确诊。由于血液供应存在差异，食管下段发生缺血性发作的倾向更高；在低血压时期，这些情况可能尤为重要。潜在的感染和动脉粥样硬化会进一步加剧血液供应，导致这些分水岭区域出现缺血。我们报告一例肺炎克雷伯菌感染患者，经鼻胃管抽吸发现有“咖啡渣样”引流物。进行了食管十二指肠镜检查，结果显示食管周向坏死。不幸的是，尽管给予了抗生素和血管活性药物支持，患者最终还是去世了。
