Clinical and endoscopic characteristics of acute esophageal necrosis and severe reflux esophagitis

Abstract

The similarities and differences between acute esophageal necrosis and severe reflux esophagitis have not been elucidated. We compared Los Angeles classification Grade C reflux esophagitis, Grade D reflux esophagitis, and acute esophageal necrosis to consider the similarities and differences between acute esophageal necrosis and severe reflux esophagitis. We retrospectively reviewed records of patients who underwent esophagogastroduodenoscopy at a tertiary referral center from January 2012 to December 2019. Data on patients diagnosed as Grade C reflux, Grade D reflux, or acute esophageal necrosis for the first time were extracted for analysis. A total of 213 patients were enrolled in the study, composed of 130 Grade C reflux, 74 Grade D reflux, and 9 acute esophageal necrosis patients. Compared to Grade C reflux patients, Grade D reflux and acute esophageal necrosis patients were more likely to be transfused (P=.013 and P=.011, respectively), to have duodenal ulcers (P=.025 and P=.049, respectively), and to have psychiatric illnesses (P=.022 and P=.018, respectively). Compared to both Grade C and D reflux, acute esophageal necrosis patients were more likely to present with shock (P=.003 and P < acute esophageal necrosis) were observed in the need for admission (P