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Acute esophageal necrosis after kidney transplantation: A case report

RATIONALE: Acute esophageal necrosis (AEN) is a rare syndrome with characteristic endoscopic and pathologic findings. It usually results from a combination of tissue hypoperfusion, impaired local defense barriers, and massive reflux of gastric contents. We report a case of AEN after a kidney transpl...

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Autores principales: Kim, Na Young, Lee, Yoo Jin, Cho, Kwang Bum, Jin, Kyubok, Lee, Ju Yup
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7886391/
https://www.ncbi.nlm.nih.gov/pubmed/33578574
http://dx.doi.org/10.1097/MD.0000000000024623
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author Kim, Na Young
Lee, Yoo Jin
Cho, Kwang Bum
Jin, Kyubok
Lee, Ju Yup
author_facet Kim, Na Young
Lee, Yoo Jin
Cho, Kwang Bum
Jin, Kyubok
Lee, Ju Yup
author_sort Kim, Na Young
collection PubMed
description RATIONALE: Acute esophageal necrosis (AEN) is a rare syndrome with characteristic endoscopic and pathologic findings. It usually results from a combination of tissue hypoperfusion, impaired local defense barriers, and massive reflux of gastric contents. We report a case of AEN after a kidney transplant. PATIENT CONCERNS: A 53-year-old man with hypertension and end-stage renal disease presented with abdominal pain and a single episode of hematemesis 14 days after kidney transplantation. DIAGNOSIS: Upper endoscopy revealed circumferential black coloration in the mid to lower esophageal mucosa. Esophageal biopsy showed ulcer, and immunostains were negative for viral etiology. INTERVENTIONS: Conservative management was done with total parenteral nutrition and proton pump inhibitor. OUTCOMES: The patient experienced no further episodes of hematemesis or abdominal pain and follow-up endoscopy showed remarkable changes from the black mucosa to a red friable mucosa with whitish exudates. LESSONS: In the case, AEN occurred in the setting of normal blood pressure after major surgery despite the absence of preceding factors such as hypotension and infections. The possibility of AEN should be considered in patients with solid organ transplantation who present with abdominal pain, dysphagia, and hematemesis.
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spelling pubmed-78863912021-02-17 Acute esophageal necrosis after kidney transplantation: A case report Kim, Na Young Lee, Yoo Jin Cho, Kwang Bum Jin, Kyubok Lee, Ju Yup Medicine (Baltimore) 4500 RATIONALE: Acute esophageal necrosis (AEN) is a rare syndrome with characteristic endoscopic and pathologic findings. It usually results from a combination of tissue hypoperfusion, impaired local defense barriers, and massive reflux of gastric contents. We report a case of AEN after a kidney transplant. PATIENT CONCERNS: A 53-year-old man with hypertension and end-stage renal disease presented with abdominal pain and a single episode of hematemesis 14 days after kidney transplantation. DIAGNOSIS: Upper endoscopy revealed circumferential black coloration in the mid to lower esophageal mucosa. Esophageal biopsy showed ulcer, and immunostains were negative for viral etiology. INTERVENTIONS: Conservative management was done with total parenteral nutrition and proton pump inhibitor. OUTCOMES: The patient experienced no further episodes of hematemesis or abdominal pain and follow-up endoscopy showed remarkable changes from the black mucosa to a red friable mucosa with whitish exudates. LESSONS: In the case, AEN occurred in the setting of normal blood pressure after major surgery despite the absence of preceding factors such as hypotension and infections. The possibility of AEN should be considered in patients with solid organ transplantation who present with abdominal pain, dysphagia, and hematemesis. Lippincott Williams & Wilkins 2021-02-12 /pmc/articles/PMC7886391/ /pubmed/33578574 http://dx.doi.org/10.1097/MD.0000000000024623 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/)
spellingShingle 4500
Kim, Na Young
Lee, Yoo Jin
Cho, Kwang Bum
Jin, Kyubok
Lee, Ju Yup
Acute esophageal necrosis after kidney transplantation: A case report
title Acute esophageal necrosis after kidney transplantation: A case report
title_full Acute esophageal necrosis after kidney transplantation: A case report
title_fullStr Acute esophageal necrosis after kidney transplantation: A case report
title_full_unstemmed Acute esophageal necrosis after kidney transplantation: A case report
title_short Acute esophageal necrosis after kidney transplantation: A case report
title_sort acute esophageal necrosis after kidney transplantation: a case report
topic 4500
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7886391/
https://www.ncbi.nlm.nih.gov/pubmed/33578574
http://dx.doi.org/10.1097/MD.0000000000024623
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