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- W2912069748 abstract "Purpose: Necrotic esophagus (also known as “black esophagus”) is a rare clinical entity with fewer than 100 cases reported in the literature. Endoscopically, the esophageal mucosa is dark or black with a macerated appearance. Pathologic review shows mucosal and submucosal necrosis. The majority of published cases of black esophagus describe the lesion in only the distal esophagus or encompassing the entire length of the esophagus. To the best or our knowledge, there have been no reported cases of black esophagus confined to the proximal esophagus. Our patient is a 79 yo male who presented initially to another hospital with chest pain associated with lightheadedness, diaphoresis and dyspnea. He was found to be bradycardic and received a dose of atropine. An ECG showed changes consistent with an inferior myocardial infarction. The patient was given aspirin, heparin, a beta-blocker and two doses of reteplase and was transferred to our facility. Four hours after the onset of chest pain the patient had a coronary catheterization at our institution. That study revealed an 80% obstructing circumflex lesion and a 100% proximal right coronary occlusion. PTCA was performed and a drug-eluting stent was deployed into the distal circumflex artery. Clopidogrel was initiated. Several hours later, the patient experienced a single episode of hematemesis. An urgent EGD was performed and showed black macerated esophageal mucosa with adherent clot in the proximal esophagus. The abnormal tissue was circumferential and was 5 cm in length. The patient was started on twice daily PPI therapy and his other medications were continued. He was later discharged without further complication. The rarity of black esophagus is likely due to the extensive arterial blood supply of the esophagus. It has been hypothesized that low-flow states may lead to transient esophageal ischemia with free radical formation and subsequent tissue injury upon reperfusion. In this patient, the isolation of black esophagus to the proximal esophagus may have been due to thromboembolism or hypotension associated with his acute coronary event." @default.
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- W2912069748 date "2007-09-01" @default.
- W2912069748 modified "2023-10-16" @default.
- W2912069748 title "Proximal Black Esophagus: A Case Report" @default.
- W2912069748 doi "https://doi.org/10.14309/00000434-200709002-00049" @default.
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