Occurrence of Acute Oesophageal Necrosis (Black Oesophagus) in a Single Tertiary Centre
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Demographics, Clinical Presentation and Comorbidities
3.2. Endoscopic Findings
3.3. Medical and Endoscopic Treatment
3.4. Outcome
4. Discussion
5. Conclusions
Author Contributions
Conflicts of Interest
References
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Physical Examination | |
---|---|
Hypotension (lower than 100/60 mmHg) | 3/16 (18.7%) |
Tachycardia (>100 bpm) | 3/16 (18.7%) |
Hypoxemia (SpO2 < 60) | 1/16 (6.2%) |
Laboratory Analysis | |
Leukocytosis (WBC > 10.000/µL) | 13/16 (81.2%) |
Increased C-reactive protein (>0.5 mg/dL) | 12 /16 (75%) |
Anaemia | 11/16 (68.7%) |
Mild | 6/11 (54.5%) |
Moderate | 2/11 (18.2%) |
Severe | 3/11 (27.3%) |
Increased glycaemia (>100 mg/dL) | 13/16 (81.2%) |
Increased creatinine (>1.5 mg/dL) | 12 /16 (75%) |
Hypoalbuminemia (<3 g/dL) * | 10/11 (90.9%) |
Indications for UGE | |
Upper GI bleeding | 13/16 (81.2%) |
Vomiting | 1/16 (6.2%) |
Worsening of anaemia | 1/16 (6.2%) |
Dysphagia | 1/16 (6.2%) |
Year of Diagnosis | Age | Gender | Chronic Comorbidities | Acute Concomitant Comorbidities | Charlson Index | Oesophageal Necrosis Extension | Duodenal Involvement | Other Endoscopic Findings | Outcome |
---|---|---|---|---|---|---|---|---|---|
2008 | 74 | M | Chronic renal failure, diabetes, chronic ischaemic heart disease and cerebral vascular disease | Acute renal failure | 5 | I-II-III | Duodenal’s ulcers | - | Discharged without follow-up endoscopy |
2009 | 76 | M | Cerebral vascular disease | Pneumonia and sepsis | 3 | I-II-III | Duodenal’s ulcers | - | Death from septic shock |
2010 | 80 | M | Chronic renal failure | Pneumonia and acute renal failure | 5 | I-II-III | Bulb’s necrosis | Necrotic aspect of pylorus | Death from multi-organ failure |
2010 | 74 | M | Chronic renal failure, dilatative cardiomyopathy and COPD | Acute renal failure | 7 | I-II-III | - | - | Lost to follow-up |
2012 | 47 | M | Diabetes, atrial fibrillation and psoriasis | Pneumonia | 3 | II- III | - | Hiatal hernia | Oesophageal stenosis |
2012 | 69 | M | Arterial hypertension, diabetes and depressive syndrome | Vertebral fracture and CD colitis | 3 | III | Duodenal’s ulcers | Hiatal hernia Mallory Weiss | Discharged without follow-up endoscopy |
2014 | 81 | M | Chronic renal failure, silicosis and brachy-tachycardia syndrome | Pneumonia | 6 | I-II-III | Duodenal’s ulcers | - | Death from multi-organ failure |
2016 | 64 | M | IV stage pancreatic adenocarcinoma | Recent NSAID assumption | 8 | II-III | Bulb’s ulcers | Hiatal hernia | Death from acute renal failure |
2016 | 65 | F | Zollinger–Ellison syndrome in metastatic NET | Vomiting and diarrhoea | 8 | I-II-III * | Duodenal’s ulcers | Hiatal hernia | Remission at follow-up UGE |
2016 | 85 | M | Alzheimer disease, decubitus lesions and atrial fibrillation | Pneumonia and CD colitis | 5 | III | Duodenal’s erosions | Death from septic shock | |
2016 | 84 | F | Zollinger–Ellison syndrome in pancreatic gastrinoma, chronic ischaemic heart disease and arteria hypertension | Pneumonia | 12 | III | Duodenal’s ulcers | Hiatal hernia | AON relapse 3 weeks after the first episode |
2017 | 87 | F | Pancreatic adenocarcinoma, chronic ischaemic heart disease, hypertension, diabetes, Parkinson disease and senile dementia | Acute renal failure | 9 | III | Duodenal’s erosions | Hiatal hernia | Death from acute renal failure |
2018 | 71 | M | Diabetes | Superficial thrombophlebitis | 4 | II- III | - | - | Remission at follow-up UGE |
2018 | 89 | M | Hypertension, diabetes, dyslipidaemia and glaucoma | Pneumonia | 5 | III | - | Hiatal hernia gastric volvolus | Death from septic shock |
2018 | 66 | M | Charcot Marie Tooth polyneuropathy, arterial hypertension and diabetes | Acute renal failure | 3 | I-II-III | Duodenal’s ulcers | - | Remission at follow-up UGE |
2018 | 77 | F | Cerebral vascular disease, Alzheimer disease, arterial hypertension and chronic renal failure | NSTEMI and acute on chronic renal failure | 7 | II-III | Necrotic areas of II portion | - | Death from multi-organ failure |
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Davide, O.; Marilia, C.; Maurizio, R.; Gianluca, E.; Domenico, C.V.; Emilio, D.G.; Bruno, A. Occurrence of Acute Oesophageal Necrosis (Black Oesophagus) in a Single Tertiary Centre. J. Clin. Med. 2019, 8, 1532. https://doi.org/10.3390/jcm8101532
Davide O, Marilia C, Maurizio R, Gianluca E, Domenico CV, Emilio DG, Bruno A. Occurrence of Acute Oesophageal Necrosis (Black Oesophagus) in a Single Tertiary Centre. Journal of Clinical Medicine. 2019; 8(10):1532. https://doi.org/10.3390/jcm8101532
Chicago/Turabian StyleDavide, Orlando, Carabotti Marilia, Ruggeri Maurizio, Esposito Gianluca, Corleto Vito Domenico, Di Giulio Emilio, and Annibale Bruno. 2019. "Occurrence of Acute Oesophageal Necrosis (Black Oesophagus) in a Single Tertiary Centre" Journal of Clinical Medicine 8, no. 10: 1532. https://doi.org/10.3390/jcm8101532