Acute esophageal necrosis occurring in a patient undergoing percutaneous coronary intervention

Korean J Intern Med. 2014 May;29(3):379-82. doi: 10.3904/kjim.2014.29.3.379. Epub 2014 Apr 29.

Abstract

Acute esophageal necrosis is uncommon in the literature. Its etiology is unknown, although cardiovascular disease, hemodynamic compromise, gastric outlet obstruction, alcohol ingestion, hypoxemia, hypercoagulable state, infection, and trauma have all been suggested as possible causes. A 67-year-old female underwent a coronary angiography (CAG) for evaluation of chest pain. CAG findings showed coronary three-vessel disease. We planned percutaneous coronary intervention (PCI). Coronary arterial dissection during the PCI led to sudden hypotension. Six hours after the index procedure, the patient experienced a large amount of hematemesis. Emergency gastrofibroscopy was performed and showed mucosal necrosis with a huge adherent blood clot in the esophagus. After conservative treatment for 3 months, the esophageal lesion was completely improved. She was diagnosed with acute esophageal necrosis. We report herein a case of acute esophageal necrosis occurring in a patient undergoing percutaneous coronary intervention.

Keywords: Cardiovascular diseases; Coronary artery diseases; Esophagus; Necrosis; Shock.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Acute Disease
  • Aged
  • Coronary Angiography
  • Coronary Stenosis / diagnosis
  • Coronary Stenosis / physiopathology
  • Coronary Stenosis / therapy*
  • Esophageal Diseases / diagnosis
  • Esophageal Diseases / drug therapy
  • Esophageal Diseases / etiology*
  • Esophagoscopy
  • Esophagus / drug effects
  • Esophagus / pathology*
  • Female
  • Hemodynamics
  • Humans
  • Necrosis
  • Percutaneous Coronary Intervention / adverse effects*
  • Predictive Value of Tests
  • Proton Pump Inhibitors / therapeutic use
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Ultrasonography, Interventional
  • Wound Healing

Substances

  • Proton Pump Inhibitors