Case Reports in Gastrointestinal Medicine / 2016 / Article / Tab 1

Case Report

An Unusual Cause of Acute Upper Gastrointestinal Bleeding: Acute Esophageal Necrosis

Table 1

Case 1Case 2

Age; sex45 yr; female66 yr; female
Clinical presentationSeptic shock, acute upper gastrointestinal bleedingDiabetic ketoacidosis, coffee ground emesis, and epigastric pain
Associated conditionMalnutrition, GERD, chronic liver disease, and alcoholismMalnutrition, coronary artery disease, hypertension, and diastolic heart failure
Hemoglobin (g/dL)9.58.5
Creatinine (mg/dL)7.11.9
Lactic acid (<2.1 mmol/L)101
Procalcitonin (>0.5 ng/mL is positive)19.71.8
Endoscopic featuresCircumferential black esophagus from mid to distal third w/intramural esophageal dissection Duodenal ulcerations with low risk stigmata for bleedingIsolated circumferential black esophagus from mid to distal third
EtiologyMalnutrition, alcoholism, chronic acid reflux, sepsis, and ischemiaDKA, systemic hypotension, ischemia, and possibly low flow ischemia
Clinical outcomeDeceasedAlive at discharge without short-term complications

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