Acute esophageal necrosis after cellulitis in an obese patient with diabetes mellitus

A 59 ‐year‐old obese Japanese man with poorly controlled type 2 diabetes mellitus presented with severe heartburn after inguinal cellulitis and exacerbated glycemic control. Emergent esophagogastroduodenoscopy showed acute esophageal necrosis, although signs of upper gastrointestinal bleeding were a bsent and a recent esophagogastroduodenoscopy was unremarkable. AbstractA 59 ‐year‐old obese Japanese man with poorly controlled type 2 diabetes mellitus presented with severe heartburn for 3 days after inguinal cellulitis and exacerbated glycemic control, without any signs of upper gastrointestinal bleeding. The patient had a high plasma glucose level (34.0 mmol/L) a nd was dehydrated. Emergent esophagogastroduodenoscopy showed black discoloration predominantly affecting the lower esophagus; thus, acute esophageal necrosis (AEN) was diagnosed. This black discoloration was not present on esophagogastroduodenoscopy 20 days prior to presentation, and disappeared 6  days after conservative treatment. To conclude, acute esophageal necrosis should be considered if a patient in marked hyperglycemic status presents with unendurable heartburn, even when upper gastrointestinal bleeding is not observed or recent esophagogastroduodenoscopy was unremarkable.
Source: Journal of Diabetes Investigation - Category: Endocrinology Authors: Tags: Case Report Source Type: research

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