Acute Esophageal Necrosis: A Successfully Managed Case

Acute esophageal necrosis is a rare condition associated with a poor prognosis. It typically presents with upper gastrointestinal bleeding, and diagnosis is established via upper gastrointestinal endoscopy. Its etiology is often multifactorial and recommendations regarding its management and treatment are scarce and of low evidence level. We present the case of an 80-year-old male with multiple medical comorbidities, who presented to the Emergency Department with upper gastrointestinal bleeding associated with sepsis of an unknown origin. Upper gastrointestinal endoscopy revealed a necrotic and ulcerated esophagus in almost its entire extension, sparing only the proximal esophagus, which is consistent with stage I acute esophageal necrosis. He was managed with supportive care and discharged home in a stable condition. This report shows that early recognition and subsequent resuscitation are the keystones of management, regardless of diagnostic uncertainty.