Year 2019 / Volume 111 / Number 9
Letter
Acute esophageal necrosis in association with acute cholecystitis

724-725

DOI: 10.17235/reed.2019.6154/2018

Emanuel Dias, Neuza Soares, Guilherme Macedo,

Abstract
We report a unique case of acute esophageal necrosis in association with perforated acute cholecystitis and secondary Klebsiella pneumoniae bacteremia. An 83-year-old male with history of diabetes mellitus, dyslipidemia, ischemic cardiomyopathy and recent right hemicolectomy for colon adenocarcinoma presented to emergency department with acute epigastric pain and hematemesis. The patient appeared cachectic and dehydrated. He was afebrile and hemodynamically stable. Laboratory studies revealed anemia, leukocytosis, hyponatremia and hyperlactatemia. Esophagogastroduodenoscopy displayed characteristic features of acute esophageal necrosis. Abdominal computerized tomography revealed acute cholecystitis with perforation contained by the liver. Percutaneous cholecystostomy was performed. Fluid therapy, intravenous pantoprazole and bowel rest were started. Klebsiella pneumoniae was cultured in blood and bile and broad-spectrum antibiotic therapy was administered. The patient improved clinically and, three weeks later, esophagogastroduodenoscopy demonstrated nearly complete healing of esophageal mucosa. To our knowledge, this is the first case of acute esophageal necrosis in association with acute cholecystitis.
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References
1. Gurvits GE, Shapsis A, Lau N, et al. Acute esophageal necrosis: a rare syndrome. Journal of gastroenterology. 2007;42(1):29-38.
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4. Gurvits GE, Cherian K, Shami MN, et al. Black esophagus: new insights and multicenter international experience in 2014. Digestive diseases and sciences. 2015;60(2):444-53.
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Dias E, Soares N, Macedo G. Acute esophageal necrosis in association with acute cholecystitis . 6154/2018


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Publication history

Received: 31/12/2018

Accepted: 15/01/2019

Online First: 23/07/2019

Published: 05/09/2019

Article Online First time: 204 days

Article editing time: 248 days


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