Acute Esophageal Necrosis: A Successfully Managed Case

TL;DR

This paper describes a rare case of acute esophageal necrosis successfully managed with supportive care in an elderly patient.

Contribution

The novelty lies in demonstrating successful management of acute esophageal necrosis through early recognition and supportive care despite diagnostic uncertainty.

Findings

Acute esophageal necrosis was diagnosed via upper gastrointestinal endoscopy in an 80-year-old male with multiple comorbidities.

The patient was successfully managed with supportive care and discharged in stable condition.

Early recognition and resuscitation are critical for managing this condition despite diagnostic uncertainty.

Abstract

Acute esophageal necrosis is a rare condition associated with a poor prognosis. It typically presents with upper gastrointestinal bleeding, and diagnosis is established via upper gastrointestinal endoscopy. Its etiology is often multifactorial and recommendations regarding its management and treatment are scarce and of low evidence level. We present the case of an 80-year-old male with multiple medical comorbidities, who presented to the Emergency Department with upper gastrointestinal bleeding associated with sepsis of an unknown origin. Upper gastrointestinal endoscopy revealed a necrotic and ulcerated esophagus in almost its entire extension, sparing only the proximal esophagus, which is consistent with stage I acute esophageal necrosis. He was managed with supportive care and discharged home in a stable condition. This report shows that early recognition and subsequent resuscitation are the keystones of management, regardless of diagnostic uncertainty.

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