Open AccessAcute esophageal necrosis in association with acute cholecystitis
Author(s) -
Emanuel Dias,
Neuza Soares,
Guilherme Macedo
Publication year - 2019
Publication title -
revista española de enfermedades digestivas/revista española de enfermedades digestivas
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.331
H-Index - 38
eISSN - 2340-4167
pISSN - 1130-0108
DOI - 10.17235/reed.2019.6154/2018
Subject(s) - medicine , esophagogastroduodenoscopy , acute pancreatitis , leukocytosis , gastroenterology , surgery , endoscopy
We report a unique case of acute esophageal necrosis in association with perforated acute cholecystitis and secondary Klebsiella pneumoniae bacteremia. An 83-year-old male with history of diabetes mellitus, dyslipidemia, ischemic cardiomyopathy and recent right hemicolectomy for colon adenocarcinoma presented to emergency department with acute epigastric pain and hematemesis. The patient appeared cachectic and dehydrated. He was afebrile and hemodynamically stable. Laboratory studies revealed anemia, leukocytosis, hyponatremia and hyperlactatemia. Esophagogastroduodenoscopy displayed characteristic features of acute esophageal necrosis. Abdominal computerized tomography revealed acute cholecystitis with perforation contained by the liver. Percutaneous cholecystostomy was performed. Fluid therapy, intravenous pantoprazole and bowel rest were started. Klebsiella pneumoniae was cultured in blood and bile and broad-spectrum antibiotic therapy was administered. The patient improved clinically and, three weeks later, esophagogastroduodenoscopy demonstrated nearly complete healing of esophageal mucosa. To our knowledge, this is the first case of acute esophageal necrosis in association with acute cholecystitis.