급성괴사식도염: 부검증례 보고 및 문헌고찰

Abstract

Acute necrotizing esophagitis (AEN), also called “black esophagus,” is a rare disorderwith an unknown pathogenesis. Endoscopic findings generally show black pigmentationthroughout the esophagus. This case also offered rare views of the grossanatomy of this disorder. Histological examination revealed that the mucosal and submucosallayers of the esophagus were involved in the severe necrotizing inflammation. The chief manifestation of this disease is hematemesis from hemorrhage of theupper gastrointestinal tract with a typically multifactorial etiology. AEN is also characterizedby a clear boundary at the gastroesophageal junction where the necrosisstops. In this study, we report an autopsy case of a 61-year-old man with necrotizinginflammation throughout the esophagus and esophageal necrosis from the laryngopharynxto the gastroesophageal junction. The patient was a disabled person with ahistory of alcohol abuse who was also diagnosed with mild coronary arteriosclerosisand fatty liver on the basis of the underlying diseases. In this case, the main etiologyfor poor perfusion from the distal esophageal area was likely underlying illness, historyof alcoholism, and malnutrition.