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Case Reports in Gastrointestinal Medicine
Volume 2017 (2017), Article ID 5092906, 3 pages
https://doi.org/10.1155/2017/5092906
Case Report

Acute Esophageal Necrosis in an Alcoholic after Successful Resuscitation from Cardiac Arrest

1Internal Medicine Department, State University of New York Upstate Medical University, 750 E Adams St, Syracuse, NY 13210, USA
2Gastroenterology Department, State University of New York Upstate Medical University, 750 E Adams St, Syracuse, NY 13210, USA
3Pulmonary/Critical Care Department, State University of New York Upstate Medical University, 750 E Adams St, Syracuse, NY 13210, USA

Correspondence should be addressed to Amish Shah

Received 15 April 2017; Revised 24 May 2017; Accepted 28 May 2017; Published 19 June 2017

Academic Editor: Shiro Kikuchi

Copyright © 2017 Amish Shah et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. We present a patient who presented to the ICU after successful resuscitation from cardiac arrest who was subsequently diagnosed with AEN. Case Presentation. A 66-year-old female presented after cardiac arrest in which return of spontaneous circulation was achieved within 7 minutes after the initiation of CPR. She was intubated on the scene and found to have coffee ground emesis in her bathroom when found unresponsive. Due to the hemodynamically significant GI bleed, patient was started on IV proton pump inhibitor, octreotide, and levophed. Subsequent endoscopy showed diffuse severe mucosal changes characterized by blackness, erythema, friability, granularity, inflammation, and decreased vascular pattern in the middle third of the esophagus and in the lower third of the esophagus. Discussion. AEN is a rare syndrome with a prevalence ranging from 0.001 to 0.2% of EGD. This patient is especially rare as this patient was female and had AEN in the middle esophagus along with lower esophagus. The pathophysiology in this patient is hypothesized that she had cardiac arrest secondary to acute upper GI hemorrhage. Subsequent low-flow state (cardiac arrest) in addition to being in the setting of severe alcohol abuse led to esophageal necrosis.