Managing Acute Esophageal Necrosis Secondary to Diabetic Ketoacidosis in a Rural Centre: A Case Report and Proposed Algorithm for Management
ABSTRACT Acute esophageal necrosis (AEN) is a rare phenomenon, usually presenting with hematemesis or melena in patients who are already unwell with concurrent pathology. We present a case of AEN in an acutely unwell 82‐year‐old man who presented in diabetic ketoacidosis (DKA). He was successfully m...
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| Format: | Article |
| Language: | English |
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Wiley
2025-03-01
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| Series: | Clinical Case Reports |
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| Online Access: | https://doi.org/10.1002/ccr3.70238 |
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| author | Annie Jiao Wang Khang Duy Ricky Le Shasha Haycock Brendan Desmond Matthew Shears |
| author_facet | Annie Jiao Wang Khang Duy Ricky Le Shasha Haycock Brendan Desmond Matthew Shears |
| author_sort | Annie Jiao Wang |
| collection | DOAJ |
| description | ABSTRACT Acute esophageal necrosis (AEN) is a rare phenomenon, usually presenting with hematemesis or melena in patients who are already unwell with concurrent pathology. We present a case of AEN in an acutely unwell 82‐year‐old man who presented in diabetic ketoacidosis (DKA). He was successfully managed in our rural centre with remote guidance from a tertiary centre. We propose an evidence‐informed management algorithm to guide and assist clinicians caring for patients with AEN in resource‐limited settings. Initial management of AEN should prioritize resuscitation and correction of any underlying pathology, such as DKA. Early endoscopic assessment is required for the diagnosis of AEN and quantification of the extent of necrosis. Early repeat endoscopy (48–72 h) is recommended to assess healing and is useful in guiding ongoing management. In resource‐limited settings, early referral and transfer for patients with AEN is recommended in the absence of intensive care support, endoscopy, or limited blood products. |
| format | Article |
| id | doaj-art-ea1c6d02e81241de98f35c3a8492b132 |
| institution | Kabale University |
| issn | 2050-0904 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Clinical Case Reports |
| spelling | doaj-art-ea1c6d02e81241de98f35c3a8492b1322025-08-20T03:39:54ZengWileyClinical Case Reports2050-09042025-03-01133n/an/a10.1002/ccr3.70238Managing Acute Esophageal Necrosis Secondary to Diabetic Ketoacidosis in a Rural Centre: A Case Report and Proposed Algorithm for ManagementAnnie Jiao Wang0Khang Duy Ricky Le1Shasha Haycock2Brendan Desmond3Matthew Shears4Department of General Surgery Northeast Health Wangaratta Wangaratta Victoria AustraliaDepartment of General Surgery Northeast Health Wangaratta Wangaratta Victoria AustraliaDepartment of General Surgery Northeast Health Wangaratta Wangaratta Victoria AustraliaDepartment of Hepatobiliary and Upper Gastrointestinal Surgery Peter MacCallum Cancer Centre Melbourne Victoria AustraliaDepartment of General Surgery Northeast Health Wangaratta Wangaratta Victoria AustraliaABSTRACT Acute esophageal necrosis (AEN) is a rare phenomenon, usually presenting with hematemesis or melena in patients who are already unwell with concurrent pathology. We present a case of AEN in an acutely unwell 82‐year‐old man who presented in diabetic ketoacidosis (DKA). He was successfully managed in our rural centre with remote guidance from a tertiary centre. We propose an evidence‐informed management algorithm to guide and assist clinicians caring for patients with AEN in resource‐limited settings. Initial management of AEN should prioritize resuscitation and correction of any underlying pathology, such as DKA. Early endoscopic assessment is required for the diagnosis of AEN and quantification of the extent of necrosis. Early repeat endoscopy (48–72 h) is recommended to assess healing and is useful in guiding ongoing management. In resource‐limited settings, early referral and transfer for patients with AEN is recommended in the absence of intensive care support, endoscopy, or limited blood products.https://doi.org/10.1002/ccr3.70238acute esophageal necrosisdiabetic ketoacidosisendoscopic surgeryGurvits syndromenecrotising esophagitisrural surgery |
| spellingShingle | Annie Jiao Wang Khang Duy Ricky Le Shasha Haycock Brendan Desmond Matthew Shears Managing Acute Esophageal Necrosis Secondary to Diabetic Ketoacidosis in a Rural Centre: A Case Report and Proposed Algorithm for Management Clinical Case Reports acute esophageal necrosis diabetic ketoacidosis endoscopic surgery Gurvits syndrome necrotising esophagitis rural surgery |
| title | Managing Acute Esophageal Necrosis Secondary to Diabetic Ketoacidosis in a Rural Centre: A Case Report and Proposed Algorithm for Management |
| title_full | Managing Acute Esophageal Necrosis Secondary to Diabetic Ketoacidosis in a Rural Centre: A Case Report and Proposed Algorithm for Management |
| title_fullStr | Managing Acute Esophageal Necrosis Secondary to Diabetic Ketoacidosis in a Rural Centre: A Case Report and Proposed Algorithm for Management |
| title_full_unstemmed | Managing Acute Esophageal Necrosis Secondary to Diabetic Ketoacidosis in a Rural Centre: A Case Report and Proposed Algorithm for Management |
| title_short | Managing Acute Esophageal Necrosis Secondary to Diabetic Ketoacidosis in a Rural Centre: A Case Report and Proposed Algorithm for Management |
| title_sort | managing acute esophageal necrosis secondary to diabetic ketoacidosis in a rural centre a case report and proposed algorithm for management |
| topic | acute esophageal necrosis diabetic ketoacidosis endoscopic surgery Gurvits syndrome necrotising esophagitis rural surgery |
| url | https://doi.org/10.1002/ccr3.70238 |
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