%0 Journal Article %T Clinical presentations, management, and outcomes of acute esophageal necrosis: a systemic review. %A Abdullah HM %A Ullah W %A Abdallah M %A Khan U %A Hurairah A %A Atiq M %J Expert Rev Gastroenterol Hepatol %V 13 %N 5 %D May 2019 %M 30933549 %F 4.095 %R 10.1080/17474124.2019.1601555 %X BACKGROUND: To review all the reported literature on acute esophageal necrosis.
METHODS: Databases were searched using the special Medical Subject Heading (MeSH) terms. All the available reported cases of acute esophageal necrosis were analyzed.
RESULTS: A total of 154 cases were identified and 130 cases were analyzed. The mean age of presentation was 61 years, and 70% of cases were males. The most common presenting symptoms were hematemesis in 66%, shock in 36%, melena in 33%, abdominal or substernal pain in 28%. The most common comorbidities reported were diabetes in 38%, hypertension in 37%, alcohol abuse in 25%, and chronic kidney disease in 16%. On upper endoscopy, 51% had a distal disease, 36% had pan esophageal, and only 2% had a proximal disease. 84% of patients were treated with IV Proton Pump Inhibitors, 22% received transfusions, 23% got antibiotics for underlying sepsis, 14% also received sucralfate, and 4% required surgery for treatment. The mortality rate was 32%, while perforation was reported in 5% and stricture formation reported in 9% of patients.
CONCLUSIONS: Patients with acute esophageal necrosis can have a favorable outcome if treated appropriately.