Acute Esophageal Necrosis in the Alcoholic Patient: Case Presentation

Abstract Acute esophageal necrosis (AEN) is an uncommon but fatal cause of upper gastrointestinal bleeding with an incidence of 0.01%–0.2%. Endoscopically, it is characterized by circumferential or diffuse black pigmentation of the esophageal mucosa, conditioned by mucosal necrosis. Risk factors include gender (male), advanced age, cardiovascular disease, hemodynamic insufficiency, alcohol consumption, diabetic ketoacidosis, malnutrition, kidney disease, and trauma. Diagnosis is based on esophagogastroduodenoscopy (EGD). Treatment of AEN consists of intravenous fluids, proton pump inhibitors (PPIs), sucralfate, parenteral nutrition, and antacids. We report a rare case from our hospital, emphasizing the importance of prompt diagnosis and intervention in case management. A 64-year-old man with a history of heavy drinking was hospitalized for severe bleeding (melena) caused by a condition called acute esophageal necrosis. He underwent an emergency procedure to examine his esophagus (EGD) and found significant damage. This case illustrates a rare etiology of AEN due to active alcohol consumption that may be overlooked. The early recognition of this clinical entity is an essential factor in the therapeutic management of the disease.