Acute esophageal necrosis ( AEN ), black esophagus , or Gurvits syndrome is a rare esophageal disorder. AEN defines itself with dark pigmentation of the esophagus , found during an upper gastrointestinal endoscopy . Pigmentation is usually black friable mucosa . The disorder is extremely rare, as only 89 patients over a span of 40 years have received this diagnosis. Specific study of the disorder's mortality rate is mentioned at 31.8%, but new research suggests mortality rates vary from 30 to 50%. The exact triggering mechanism for this disorder is still unknown, but is likely multifactorial.
15-712: AEN is may refer to: Acute esophageal necrosis , a rare esophageal disorder A+E Networks , a media organization based in the United States AEN Ayiou Georgiou Vrysoullon-Acheritou , an association football club in the Agios Georgios refugee settlement in Cyprus Alliance for Europe of the Nations , a pan-European political party Alfred E. Neuman ,
30-510: A fictional character in MAD magazine Armenian Environmental Network Armenian Sign Language asynchronous event notification in (for example) the NC-SI electrical interface Topics referred to by the same term [REDACTED] This disambiguation page lists articles associated with the title AEN . If an internal link led you here, you may wish to change the link to point directly to
45-475: A variety of etiologies. Currently, there is no direct treatment for AEN. Only treatment is for the underlying main diseases or conditions. Appropriate hydration is set. Antacids are also added for further recovery support. Common support drugs of antacids are either H 2 receptor antagonists , and/or a proton pump inhibitor . Sucralfate was used as an option. Parenteral nutrition greatly increased chance of recovery. An esophagectomy can be issued if
60-569: Is due to acid oversecretion. It is not FDA approved for gastric ulcers , but is widely used because of evidence of efficacy. The use for sucralfate in peptic ulcer disease has diminished recently, but it is still the preferred agent for stress ulcer prevention. Sucralfate has also been used for the following conditions: The most common side effect seen is constipation (2–3%). Less commonly reported side effects (<0.5%) include flatulence , headache , hypophosphatemia , xerostomia (dry mouth), and bezoar formation. Use of this drug
75-405: Is limited. It is used by mouth (for upper GIT ulcers) and rectally (for radiation proctitis). Common side effects include constipation . Serious side effects may include bezoar formation and encephalopathy . Use appears to be safe in pregnancy and breastfeeding . How it works is unclear but is believed to involve binding to the ulcer and protecting it from further damage. Sucralfate
90-403: Is not recommended for people with chronic kidney failure , as it might cause aluminium accumulation and toxicity . A few well-controlled studies have been carried out investigating the safety and efficacy of sucralfate in children and pregnant women ( Pregnancy Category B). Sucralfate is a locally acting substance that in an acidic environment (pH < 4) reacts with hydrochloric acid in
105-403: Is reported, and is very commonly represented in elderly patients. Black or bloody stools and hematemesis account for over three quarters of the case presentations. Abdominal pain, nausea, vomiting, and unstable vital signs are common. A cardiovascular event (such as a heart attack ) was reported in ten percent of the total known cases. Having cancer (current or previous) is currently one of
120-585: The stomach to form a cross-linking, viscous , paste-like material capable of acting as an acid buffer for as long as 6 to 8 hours after a single dose . It also attaches to proteins on the surface of ulcers, such as albumin and fibrinogen , to form stable insoluble complexes. These complexes serve as protective barriers at the ulcer surface, preventing further damage from acid , pepsin , and bile . In addition, sucralfate prevents back diffusion of hydrogen ions , and absorbs both pepsin and bile acids . It has been thought that sucralfate also stimulates
135-412: The disorder is severe enough. The prognosis for acute esophageal necrosis is generally poor, as the condition is associated with a high risk of mortality (up to 32%). Most mortality is attributed to the underlying cause; mortality specifically caused by AEN is about 6 percent. Acute esophageal necrosis made an appearance on an American medical drama show, Dr. G: Medical Examiner . Jan Garavaglia ,
150-444: The first-ever systemic review on acute esophageal necrosis and reviewed around 154 patients reported in the literature at the time of publishing. Sucralfate Sucralfate , sold under various brand names, is a medication used to treat stomach ulcers , gastroesophageal reflux disease (GERD), radiation proctitis , and stomach inflammation and to prevent stress ulcers . Its usefulness in people infected by H. pylori
165-461: The intended article. Retrieved from " https://en.wikipedia.org/w/index.php?title=AEN&oldid=1061225692 " Category : Disambiguation pages Hidden categories: Short description is different from Wikidata All article disambiguation pages All disambiguation pages Acute esophageal necrosis AEN has never been recorded as a one symptom disorder, but instead present by multiple symptoms. The symptoms vary from
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#1732798460261180-434: The most prevalent out of all conditions among patients. High blood pressure , Chronic lung conditions , Alcohol use disorder , excessive alcohol use combined with other recreational drug use (e.g. cocaine), Kidney failure , and malnutrition are other major risk factors. Acute esophageal necrosis can only be diagnosed by an upper gastrointestinal endoscopy. It is usually preceded by haemodynamic stress, which can have
195-442: The severity of the disorder. The most classic sign of AEN is the dark pigmentation of esophageal mucosa in an upper endoscopy, usually viewed as an ulcer or as an infectious disease. Necrosis can be found mostly between the three distals of the esophagus, but stops abruptly at the gastroesophageal junction . The basic and most common symptoms reported are blood in stool and blood in vomiting . Upper gastrointestinal bleeding then
210-519: The show's host, receives a female body, that at time of the autopsy had a severe case of acute esophageal necrosis due to alcohol use disorder . Acute esophageal necrosis was first described by Goldenberg et al. in 1990. Cases have emerged since 1960, but have never been described as the common names for AEN. Due to its rarity, only 88 cases have been pronounced AEN, but most likely there are many more. Gurvits et al. describes AEN as "poorly described in medical literature". Abdullah et al . published
225-481: Was approved for medical use in the United States in 1981. It is available as a generic medication . In 2022, it was the 214th most commonly prescribed medication in the United States, with more than 1 million prescriptions. Sucralfate is used for the treatment of active duodenal ulcers not related to the use of nonsteroidal anti-inflammatory drugs (NSAIDs), as the mechanism behind these ulcers
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