Acute esophageal necrosis: A rare but potentially life-threatening condition—Insights from a case series

Acute esophageal necrosis (AEN) is a rare and severe entity characterized by diffuse necrosis of the mucosa, mainly in the distal esophagus, with a mortality rate close to 40%. We present herein six cases diagnosed through upper gastrointestinal endoscopy. The mean patient age was 62 years (range 33-86) and females were predominant (5/6). The most frequent comorbidities were diabetes mellitus and high blood pressure (5/6, each entity). The main symptoms included melena, hematemesis, and epigastric pain. Two patients presented with diabetic ketoacidosis and sepsis. Endoscopy revealed diffuse necrosis in all the cases and perforation in two cases. Two patients were discharged from the hospital, one received palliative care, and two died due to multiple organ failure (40% mortality). Management included proton pump inhibitors, antibiotics, antifungals, and nutritional support. AEN requires early diagnosis and a multidisciplinary approach to prevent major complications, such as bleeding and perforation.