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Occurrence of Acute Oesophageal Necrosis (Black Oesophagus) in a Single Tertiary Centre.
J Clin Med. 2019 09 24; 8(10)JC

Abstract

Acute oesophageal necrosis (AON) is a rare condition characterised by the endoscopic finding of diffuse, circumferential, black mucosal pigmentation of the oesophagus, which typically stops at the gastro-oesophageal junction. This observational study aimed to assess the occurrence, clinical characteristics and outcomes of AON in a consecutive endoscopic cohort in a single tertiary university centre. A retrospective analysis of endoscopic data of upper gastrointestinal endoscopy (UGE) was carried out from 2008 to 2018. Out of 25,970 UGE, 16 patients (0.06%) had AON; 75.0% were men with a median age of 75 years. Almost all patients underwent diagnosis during emergency UGE performed for gastrointestinal bleeding, but one patient was diagnosed during elective UGE for persistent vomiting and diarrhoea. All patients reported one or more pre-existing comorbidities and concomitant acute events. Two patients had AON as the first presentation of Zollinger-Ellison syndrome (ZES). One patient developed an oesophageal stenosis, and another patient presented a relapse of AON. Mortality was 50%, but no patient died as a direct consequence of AON. AON is a rare cause of gastrointestinal bleeding diagnosed mainly during emergency UGE. Our study showed that ZES might manifest with this critical presentation, and endoscopists must be aware of this evidence.

Authors+Show Affiliations

Medical-Surgical Department of Clinical Sciences and Translational Medicine, Sant'Andrea Hospital, University Sapienza, 00189 Rome, Italy. davidegiuseppeorlando@hotmail.it.Medical-Surgical Department of Clinical Sciences and Translational Medicine, Sant'Andrea Hospital, University Sapienza, 00189 Rome, Italy. mariliacarabotti@gmail.com.Medical-Surgical Department of Clinical Sciences and Translational Medicine, Sant'Andrea Hospital, University Sapienza, 00189 Rome, Italy. maurizio.ruggeri@gmail.com.Medical-Surgical Department of Clinical Sciences and Translational Medicine, Sant'Andrea Hospital, University Sapienza, 00189 Rome, Italy. gle.esposito@gmail.com.Medical-Surgical Department of Clinical Sciences and Translational Medicine, Sant'Andrea Hospital, University Sapienza, 00189 Rome, Italy. vito.corleto@gmail.com.Medical-Surgical Department of Clinical Sciences and Translational Medicine, Sant'Andrea Hospital, University Sapienza, 00189 Rome, Italy. edigiulio52@gmail.com.Medical-Surgical Department of Clinical Sciences and Translational Medicine, Sant'Andrea Hospital, University Sapienza, 00189 Rome, Italy. bruno.annibale@uniroma1.it.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31554345

Citation

Orlando, Davide, et al. "Occurrence of Acute Oesophageal Necrosis (Black Oesophagus) in a Single Tertiary Centre." Journal of Clinical Medicine, vol. 8, no. 10, 2019.
Orlando D, Carabotti M, Ruggeri M, et al. Occurrence of Acute Oesophageal Necrosis (Black Oesophagus) in a Single Tertiary Centre. J Clin Med. 2019;8(10).
Orlando, D., Carabotti, M., Ruggeri, M., Esposito, G., Corleto, V. D., Di Giulio, E., & Annibale, B. (2019). Occurrence of Acute Oesophageal Necrosis (Black Oesophagus) in a Single Tertiary Centre. Journal of Clinical Medicine, 8(10). https://doi.org/10.3390/jcm8101532
Orlando D, et al. Occurrence of Acute Oesophageal Necrosis (Black Oesophagus) in a Single Tertiary Centre. J Clin Med. 2019 09 24;8(10) PubMed PMID: 31554345.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Occurrence of Acute Oesophageal Necrosis (Black Oesophagus) in a Single Tertiary Centre. AU - Orlando,Davide, AU - Carabotti,Marilia, AU - Ruggeri,Maurizio, AU - Esposito,Gianluca, AU - Corleto,Vito Domenico, AU - Di Giulio,Emilio, AU - Annibale,Bruno, Y1 - 2019/09/24/ PY - 2019/09/03/received PY - 2019/09/19/revised PY - 2019/09/22/accepted PY - 2019/9/27/entrez PY - 2019/9/27/pubmed PY - 2019/9/27/medline KW - Zollinger–Ellison syndrome KW - acute oesophageal necrosis KW - black oesophagus KW - gastrointestinal bleeding KW - oesophageal stenosis KW - upper gastrointestinal endoscopy JF - Journal of clinical medicine JO - J Clin Med VL - 8 IS - 10 N2 - Acute oesophageal necrosis (AON) is a rare condition characterised by the endoscopic finding of diffuse, circumferential, black mucosal pigmentation of the oesophagus, which typically stops at the gastro-oesophageal junction. This observational study aimed to assess the occurrence, clinical characteristics and outcomes of AON in a consecutive endoscopic cohort in a single tertiary university centre. A retrospective analysis of endoscopic data of upper gastrointestinal endoscopy (UGE) was carried out from 2008 to 2018. Out of 25,970 UGE, 16 patients (0.06%) had AON; 75.0% were men with a median age of 75 years. Almost all patients underwent diagnosis during emergency UGE performed for gastrointestinal bleeding, but one patient was diagnosed during elective UGE for persistent vomiting and diarrhoea. All patients reported one or more pre-existing comorbidities and concomitant acute events. Two patients had AON as the first presentation of Zollinger-Ellison syndrome (ZES). One patient developed an oesophageal stenosis, and another patient presented a relapse of AON. Mortality was 50%, but no patient died as a direct consequence of AON. AON is a rare cause of gastrointestinal bleeding diagnosed mainly during emergency UGE. Our study showed that ZES might manifest with this critical presentation, and endoscopists must be aware of this evidence. SN - 2077-0383 UR - https://www.unboundmedicine.com/medline/citation/31554345/Occurrence_of_Acute_Oesophageal_Necrosis_(Black_Oesophagus)_in_a_Single_Tertiary_Centre L2 - http://www.mdpi.com/resolver?pii=jcm8101532 DB - PRIME DP - Unbound Medicine ER -
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