Acute esophageal necrosis syndrome is a rare cause of gastrointestinal bleeding. It is characterized by a particular black coloration, mostly of the distal esophagus, which ends abruptly in the gastroesophageal junction. The hemorrhagic manifestation may be hematemesis, melena, or both of them. It is a life-threatening condition with significant differences between the two sexes.
We report a case of a 67 years old male with schizophrenia, aspiration pneumonia, and sepsis who presented with hematemesis. The endoscopic finding was a black, wide linear necrosis of the esophageal mucosa which extended from the middle esophagus to the gastroesophageal junction, compatible with acute esophageal necrosis. The esophageal lesion healed progressively at the same time with the improvement of the general health condition.
We must think of acute esophageal necrosis in critically ill male patients, in their sixth decade of life, with multiple comorbidities and gastrointestinal hemorrhage, because early recognition can help reduce the mortality of this rare syndrome.
In conclusion, we must think of acute esophageal necrosis in critically ill male patients, in their sixth decade of life, with multiple comorbidities and gastrointestinal hemorrhage. The diagnosis is made most of the time only by the characteristic endoscopic findings. Because of the gravity of this affection, the treatment must be quick and aggressive.
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