Abstract:
Acute esophageal necrosis is a rare condition, characterized by a distinctive endoscopic/necropsic image-circumferential black area of the esophagus. This paper presents a case of a 78-year-old patient with recent history of a severe form of COVID-19 (2 months previously), with multiple comorbidities, which presents sudden death in hospital. Anatomic-pathological autopsy showed extensive esophageal necrosis, pulmonary thromboses, and coronarian and aortic atherosclerosis. The histopathological examination revealed necrosis of the esophageal mucosa and phlegmonous inflammation extended to the mediastinum, chronic pneumonia with pulmonary fibrosis, viral myocarditis, papillary muscle necrosis, and pericoronary neuritis. Thromboses and necroses were identified also in the liver, pancreas, and adrenal glands. Post-COVID-19 thromboses can manifest late, affecting various vascular territories, including esophageal ones. Their clinical picture may be diminished or absent in elderly and/or diabetic patients.
摘要:
急性食管坏死是一种罕见的疾病,其特征是独特的内窥镜/尸检图像-食管的周围黑色区域。本文介绍了一名78岁的患者,该患者最近有严重形式的COVID-19病史(2个月前),有多种合并症,这表明在医院突然死亡。解剖-病理尸检显示广泛的食管坏死,肺血栓形成,冠状动脉粥样硬化和主动脉粥样硬化。组织病理学检查显示食管粘膜坏死和痰质炎症延伸至纵隔,慢性肺炎合并肺纤维化,病毒性心肌炎,乳头状肌坏死,和冠状动脉周围神经炎.在肝脏中也发现了血栓和坏死,胰腺,和肾上腺.COVID-19后血栓形成可以晚期显现,影响各种血管区域,包括食道的.老年人和/或糖尿病患者的临床表现可能会减弱或缺失。