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Acute oesophageal necrosis: an important differential in the elderly population with haematemesis
  1. Sophie Laverick,
  2. Udoka Ogbuneke,
  3. Ioannis Koumoutsos and
  4. Zahed Ahmed
  1. Gastroenterology, Southend University Hospital NHS Foundation Trust, Westcliff-on-Sea, UK
  1. Correspondence to Dr Sophie Laverick; sophievs{at}doctors.org.uk

Abstract

Acute oesophageal necrosis is a rare cause of haematemesis associated with high mortality and morbidity in elderly patients with multiple comorbidities. Acute oesophageal necrosis is thought to be caused by a combination of hypoperfusion, vascular disease and duodenal disease causing transient gastric outlet obstruction and therefore reflux of gastric contents. The subsequent necrosis is associated with significant morbidity and mortality. We present a case of an 83-year-old man presenting with sepsis secondary to gallstone cholangitis, who developed haematemesis 2 days post admission. Oesopho-gastro-duodenoscopy demonstrated necrosis to the oesophagus and duodenal ulceration. This was the first case of acute oesophageal necrosis observed within our hospital. We review the literature on the management of acute oesophageal necrosis and discuss the impact of acute oesophageal necrosis and its complications on the patient’s long-term outcome.

  • endoscopy
  • GI bleeding

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Footnotes

  • Contributors Case report written by SL and UO. The report has then been reviewed and revised by IK and ZA.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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