Endoscopy 2005; 37(3): 268-271
DOI: 10.1055/s-2005-860995
Case Report
© Georg Thieme Verlag KG Stuttgart · New York

Acute Esophageal Necrosis Associated with Alcoholic Hepatitis: Is It Black or Is It White?

A.  Săftoiu1 , S.  Cazacu1 , A.  Kruse2 , C.  Georgescu3 , V.  Comănescu1 , T.  Ciurea 1
  • 1Department of Gastroenterology, Faculty of Medicine, University of Medicine and Pharmacy, Craiova, Romania
  • 2Department of Surgery L, Endoscopy Laboratory, University Hospital Aarhus, Denmark
  • 3Department of Pathology, Faculty of Medicine, University of Medicine and Pharmacy, Craiova, Romania
Weitere Informationen

Publikationsverlauf

Submitted 9 June 2004

Accepted after Revision 21 September 2004

Publikationsdatum:
24. Februar 2005 (online)

Abstract

Acute esophageal necrosis is an uncommon condition diagnosed during endoscopy from the black appearance of the esophagus. We report three cases of acute esophageal necrosis, associated with severe alcoholic hepatitis. The pathogenesis was multifactorial in our patients, with gastroesophageal reflux combined with hypoperfusion probably being the key factor for the esophageal lesions. The patients presented a continuum of endoscopic appearances, ranging from the characteristic black esophageal mucosa with ulcerations to a thick white exudate that peeled away (pseudomembranes). However, esophageal biopsy specimens from all three patients had the same histological pattern of severe inflammation and necrosis. Thus, the possibility of acute esophageal necrosis should also be considered in patients with extensive necrosis covered by a white exudate, but without the characteristic pattern of a ”black esophagus”; and the diagnosis should subsequently be confirmed by mucosal biopsies. Our report showed that ethanol-induced acute esophageal necrosis can appear in patients with a high alcohol intake, especially in immunosupressed patients with alcoholic hepatitis.

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A. Săftoiu, M.D., PhD

Department of Gastroenterology, Faculty of Medicine, University of Medicine and Pharmacy Craiova

Str. Horia nr. 11 · Craiova · Dolj, 200490 · Romania

Fax: +40-251-534596

eMail: adry@umfcv.ro