Acute esophageal necrosis

Abstract

The article presents the description of such a rare pathology as an acute esophageal necrosis in the patient with acute disorders of cerebral circulation treated at the neurology department of Vitebsk regional hospital. The patient was repeatedly hospitalized with stroke (at first he had it in May, 2015). While being treated at the neurology department, the patient was diagnosed an acute esophageal necrosis present with upper gastrointestinal bleeding. The patient was examined by the brigade on duty and sent to the intensive care unit where the activities for examination, treatment and preparation for surgery were conducted. Abdominal ultrasound, fibroesophagogastroduodenoscopy, chest computed tomography and drainage of the right and left pleural cavities were carried out. However, during the preoperative preparation on the background of progressive phenomena of multiple organ failure the patient died. The autopsy established delimited necrosis of the middle and lower thirds of the esophageal mucosa, at the same time the mucous membranes of the pharynx, the upper third of the esophagus and the stomach were intact. The ulcerous-necrotic changes in the mucous and submucosal layers were revealed histologically. The causes of the acute esophageal necrosis are still unknown. It can be assumed effect of possible precipitating factors on esophageal mucosa. The represented observation testifies that even preventive appointment of proton pump blockers and drugs affecting the motility of the intestine unableto prevent the development of acute esophageal necrosis. The described case demonstrates the possibility of occurrence of such a situation when a patient needs emergency surgery.