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Medication-induced acute esophageal necrosis: a case report
1North Karelia Central Hospital, Tikkamäentie 16, 80210, Joensuu, Finland. lauri.pautola@pkssk.fi.
Journal of Medical Case Reports
|September 30, 2016
Summary
Accidental ingestion of clozapine and olanzapine led to acute esophageal necrosis (Gurvits syndrome) in a patient. This case highlights the potential gastrointestinal risks of these antipsychotic medications.
Area of Science:
- Gastroenterology
- Pharmacology
- Toxicology
Background:
- Acute esophageal necrosis, or Gurvits syndrome, is a rare condition.
- It is characterized by necrotic esophageal mucosa at the gastroesophageal junction.
- Etiology is multifactorial, often linked to low-flow states.
Purpose of the Study:
- To report an unprecedented case of acute esophageal necrosis.
- To investigate the potential role of accidental medication ingestion in its development.
Main Methods:
- A case presentation of a 65-year-old male patient.
- Involved accidental ingestion of multiple medications, including clozapine and olanzapine.
- Diagnostic procedures included endoscopy, CT scan, and laparotomy.
Main Results:
- The patient presented with vomiting, tachycardia, and fever.
- Endoscopy confirmed necrotic esophageal mucosa consistent with Gurvits syndrome.
- The patient recovered fully within a week without surgical intervention.
Conclusions:
- Clozapine and olanzapine are suspected to be the cause of acute esophageal necrosis in this case.
- This is analogous to reported cases of ischemic colitis linked to these drugs.
- Clinicians should consider these medications as potential causes of acute ischemic enteropathy.
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