Acute Esophageal Necrosis as an Unusual Cause of Epigastric Pain in the Emergency Department
Epigastric pain is a common complaint in the emergency department (ED). Clinicians require skills to differentiate the epigastric pain in the ED. Here, we report a case of acute esophageal necrosis (AEN) as a cause of epigastric pain in the ED. An 83-year-old woman with diabetes mellitus visited the...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Karger Publishers
2022-11-01
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| Series: | Case Reports in Acute Medicine |
| Subjects: | |
| Online Access: | https://www.karger.com/Article/FullText/527291 |
| _version_ | 1811206120313716736 |
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| author | Tomoki Ito Kasumi Satoh Kotaro Sakaki Masaru Sakusabe |
| author_facet | Tomoki Ito Kasumi Satoh Kotaro Sakaki Masaru Sakusabe |
| author_sort | Tomoki Ito |
| collection | DOAJ |
| description | Epigastric pain is a common complaint in the emergency department (ED). Clinicians require skills to differentiate the epigastric pain in the ED. Here, we report a case of acute esophageal necrosis (AEN) as a cause of epigastric pain in the ED. An 83-year-old woman with diabetes mellitus visited the ED because of worsening subacute epigastric pain, nausea, and anorexia. The patient’s vital signs and general condition did not seem serious at first in the ED. Esophagogastroduodenoscopy revealed circumferential inflammation and necrosis of the esophageal mucosa. The patient was diagnosed with AEN and admitted. The patient’s condition suddenly worsened on the sixth day. Citrobacter koseri was detected in blood culture, and although the patient was treated with antibiotics, she died on the twelfth day. In our case, epigastric pain, a common complaint in the ED in elderly women, was caused by AEN, an uncommon disease. The patient was seemingly stable at first but rapidly developed sepsis and died. In this case, we identified two important clinical issues: (1) AEN is an uncommon cause of epigastric pain in the ED, but it is worth considering. (2) Once AEN is diagnosed, the clinician should engage in further investigations such as esophageal and blood culture tests and close follow-up of the clinical course, even if patients’ condition does not appear to be serious. |
| first_indexed | 2024-04-12T03:42:29Z |
| format | Article |
| id | doaj.art-c614b9b71fb542ff967503651ff29444 |
| institution | Directory Open Access Journal |
| issn | 2504-5288 |
| language | English |
| last_indexed | 2024-04-12T03:42:29Z |
| publishDate | 2022-11-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Acute Medicine |
| spelling | doaj.art-c614b9b71fb542ff967503651ff294442022-12-22T03:49:15ZengKarger PublishersCase Reports in Acute Medicine2504-52882022-11-0152-361110.1159/000527291527291Acute Esophageal Necrosis as an Unusual Cause of Epigastric Pain in the Emergency DepartmentTomoki Ito0Kasumi Satoh1https://orcid.org/0000-0002-2182-3108Kotaro Sakaki2Masaru Sakusabe3Department of Emergency and General Medicine, Akita Kousei Medical Center, Akita, JapanGeneral Physician Center, Akita University Hospital, Akita, JapanDepartment of Gastroenterology Medicine, Akita Kousei Medical Center, Akita, JapanDepartment of Emergency and General Medicine, Akita Kousei Medical Center, Akita, JapanEpigastric pain is a common complaint in the emergency department (ED). Clinicians require skills to differentiate the epigastric pain in the ED. Here, we report a case of acute esophageal necrosis (AEN) as a cause of epigastric pain in the ED. An 83-year-old woman with diabetes mellitus visited the ED because of worsening subacute epigastric pain, nausea, and anorexia. The patient’s vital signs and general condition did not seem serious at first in the ED. Esophagogastroduodenoscopy revealed circumferential inflammation and necrosis of the esophageal mucosa. The patient was diagnosed with AEN and admitted. The patient’s condition suddenly worsened on the sixth day. Citrobacter koseri was detected in blood culture, and although the patient was treated with antibiotics, she died on the twelfth day. In our case, epigastric pain, a common complaint in the ED in elderly women, was caused by AEN, an uncommon disease. The patient was seemingly stable at first but rapidly developed sepsis and died. In this case, we identified two important clinical issues: (1) AEN is an uncommon cause of epigastric pain in the ED, but it is worth considering. (2) Once AEN is diagnosed, the clinician should engage in further investigations such as esophageal and blood culture tests and close follow-up of the clinical course, even if patients’ condition does not appear to be serious.https://www.karger.com/Article/FullText/527291esophageal diseasessepsisdifferential diagnosis |
| spellingShingle | Tomoki Ito Kasumi Satoh Kotaro Sakaki Masaru Sakusabe Acute Esophageal Necrosis as an Unusual Cause of Epigastric Pain in the Emergency Department Case Reports in Acute Medicine esophageal diseases sepsis differential diagnosis |
| title | Acute Esophageal Necrosis as an Unusual Cause of Epigastric Pain in the Emergency Department |
| title_full | Acute Esophageal Necrosis as an Unusual Cause of Epigastric Pain in the Emergency Department |
| title_fullStr | Acute Esophageal Necrosis as an Unusual Cause of Epigastric Pain in the Emergency Department |
| title_full_unstemmed | Acute Esophageal Necrosis as an Unusual Cause of Epigastric Pain in the Emergency Department |
| title_short | Acute Esophageal Necrosis as an Unusual Cause of Epigastric Pain in the Emergency Department |
| title_sort | acute esophageal necrosis as an unusual cause of epigastric pain in the emergency department |
| topic | esophageal diseases sepsis differential diagnosis |
| url | https://www.karger.com/Article/FullText/527291 |
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