The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지
DOI QR코드

DOI QR Code

A Case of Acute Esophageal Necrosis in a Patient with Diabetic Ketoacidosis

당뇨병성 케톤산증 환자에서 발생한 급성식도괴사 1예

  • Im, Jae-Hyoung (Department of Internal Medicine, Inha University School of Medicine) ;
  • Kim, Min-Su (Department of Internal Medicine, Inha University School of Medicine) ;
  • Lee, Seung-Yoen (Department of Internal Medicine, Inha University School of Medicine) ;
  • Kim, So-Hun (Department of Internal Medicine, Inha University School of Medicine) ;
  • Hong, Seong-Bin (Department of Internal Medicine, Inha University School of Medicine) ;
  • Nam, Moon-Suk (Department of Internal Medicine, Inha University School of Medicine) ;
  • Kim, Yong-Seong (Department of Internal Medicine, Inha University School of Medicine)
  • 임재형 (인하대학교 의학전문대학원 내과학교실) ;
  • 김민수 (인하대학교 의학전문대학원 내과학교실) ;
  • 이승연 (인하대학교 의학전문대학원 내과학교실) ;
  • 김소헌 (인하대학교 의학전문대학원 내과학교실) ;
  • 홍성빈 (인하대학교 의학전문대학원 내과학교실) ;
  • 남문석 (인하대학교 의학전문대학원 내과학교실) ;
  • 김용성 (인하대학교 의학전문대학원 내과학교실)
  • Published : 2012.07.01
⟨ Previous Next ⟩

Abstract

Acute esophageal necrosis is a rare clinical entity characterized by the endoscopic finding of extensive black discoloration of the esophageal mucosa. Acute esophageal necrosis in a patient with diabetic ketoacidosis has rarely been reported. We report a case of acute esophageal necrosis in a patient with diabetic ketoacidosis. The patient had coffee ground emesis and, after an esophagogastroduodenoscopy with mucosal biopsy, acute esophageal necrosis was diagnosed. The patient was treated conservatively with an intravenous proton pump inhibitor and oral sucralfate without any complications.

저자들은 39세 환자에서 발생한 당뇨병성 케톤산증에 동반된 급성식도괴사의 드문 증례를 경험하였다. 급성식도괴사는 치명적인 합병증을 가져 올 수 있는 질환으로 당뇨병성 케톤산증 환자에서 토혈이나 가슴통증이 있는 경우 이의 가능성을 고려해야 하겠다. 또한 진단 후에는 금식, proton pump inhibitor 등으로 대증적 치료를 하며 식도파열, 협착 및 종격동염 등의 심각한 합병증 발병 여부에 유의해야겠다.

Keywords

References

  1. Sako A, Kitayama J, Inoue T, Kaizaki S, Nagawa H, Suzuki H. Black oesophagus: cause? Gut 2005;54:192, 227.
  2. Augusto F, Fernandes V, Cremers MI, et al. Acute necrotizing esophagitis: a large retrospective case series. Endoscopy 2004;36:411-415. https://doi.org/10.1055/s-2004-814318
  3. Grudell AB, Mueller PS, Viggiano TR. Black esophagus: report of six cases and review of the literature, 1963-2003. Dis Esophagus 2006;19:105-110. https://doi.org/10.1111/j.1442-2050.2006.00549.x
  4. Gurvits GE. Black esophagus: acute esophageal necrosis syndrome. World J Gastroenterol 2010;16:3219-3225. https://doi.org/10.3748/wjg.v16.i26.3219
  5. Long JD, Orlando RC. Anatomy, histology, embryology, and developmental anomalies of the esophagus. In: Feldman M, Friedman LS, Brandt LJ, eds. Gastrointestinal and Liver Disease. 8th ed. Philadelphia: Saunders Elsevier, 2006:841-853.
  6. Faigel DO, Metz DC. Prevalence, etiology, and prognostic significance of upper gastrointestinal hemorrhage in diabetic ketoacidosis. Dig Dis Sci 1996;41:1-8. https://doi.org/10.1007/BF02208576
  7. Cattan P, Cuillerier E, Cellier C, et al. Black esophagus associated with herpes esophagitis. Gastrointest Endosc 1999;49:105-107. https://doi.org/10.1016/S0016-5107(99)70455-4
  8. Gurvits GE, ShapsisA, Lau N, Gualtieri N, Robilotti JG. Acute esophageal necrosis: a rare syndrome. J Gastroenterol 2007;42:29-38.
  9. Kim YH, Choi SY. Black esophagus with concomitant candidiasis developed after diabetic ketoacidosis. World J Gastroenterol 2007;13:5662-5663.
  10. Casella G, Perego D, Corti G, et al. Black esophagus: should it be considered an unfavorable prognostic factor? Dis Esophagus 2001;14:166-168. https://doi.org/10.1046/j.1442-2050.2001.00177.x

Cited by

  1. Black Esophagus: New Insights and Multicenter International Experience in 2014 vol.60, pp.2, 2015, https://doi.org/10.1007/s10620-014-3382-1
  2. Acute Esophageal Necrosis: A View in the Dark vol.13, pp.1, 2012, https://doi.org/10.1159/000496385