Acute Necrotizing Esophagitis: An Autopsy Case Report and Literature Review. |
Minsung Choi, Go Un Jung, Yun Teak Shim, Hyung Nam Koo, Byung Ha Choi, Nak Eun Chung, Young Shik Choi, Yi Suk Kim |
1Forensic Medicine Division, Daejeon Institute of Scientific Investigation, Daejeon, Korea. 2Department of Anatomy, Ewha Womans University School of Medicine, Seoul, Korea. jwkiss@ewha.ac.kr 3Department of Forensic Medicine Investigation, Seoul Institute of Scientific Investigation, Seoul, Korea. 4Forensic Medical Center, National Forensic Service, Wonju-si, Gangwon-do, Korea. 5Seoul Institute of Scientific Investigation, Seoul, Korea. |
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Abstract |
Acute necrotizing esophagitis (AEN), also called "black esophagus," is a rare disorder with an unknown pathogenesis. Endoscopic findings generally show black pigmentation throughout the esophagus. This case also offered rare views of the gross anatomy of this disorder. Histological examination revealed that the mucosal and submucosal layers of the esophagus were involved in the severe necrotizing inflammation. The chief manifestation of this disease is hematemesis from hemorrhage of the upper gastrointestinal tract with a typically multifactorial etiology. AEN is also characterized by a clear boundary at the gastroesophageal junction where the necrosis stops. In this study, we report an autopsy case of a 61-year-old man with necrotizing inflammation throughout the esophagus and esophageal necrosis from the laryngopharynx to the gastroesophageal junction. The patient was a disabled person with a history of alcohol abuse who was also diagnosed with mild coronary arteriosclerosis and fatty liver on the basis of the underlying diseases. In this case, the main etiology for poor perfusion from the distal esophageal area was likely underlying illness, history of alcoholism, and malnutrition. |
Key Words:
Acute esophageal necrosis, Black esophagus, Hematemesis, Autopsy |
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