Acute esophageal necrosis: A systematic review and pooled analysis

Area of Science:

• Gastroenterology
• Esophageal Diseases
• Medical Research

Background:

• Acute esophageal necrosis (AEN) is an uncommon condition with diverse causes, often manifesting as upper gastrointestinal bleeding.
• The lower esophagus is the most frequently affected site in AEN cases.

Purpose of the Study:

• To systematically review existing data on the demographics, clinical presentation, outcomes, and management of acute esophageal necrosis.
• To identify factors associated with complications and mortality in AEN patients.

Main Methods:

• A comprehensive systematic literature search was conducted following PRISMA guidelines.
• Data extraction on study design, patient characteristics, interventions, and outcomes was performed by two independent reviewers.

Main Results:

• The review identified 114 patients with AEN, predominantly males (mean age 62.1 years), with 85% presenting with gastrointestinal bleeding symptoms.
• Conservative management was the primary approach (75.4%), though surgical or endoscopic interventions increased significantly over time (9.7% vs. 30.1%).
• Mortality was observed in 29.9% of patients, with gastrointestinal symptoms and the need for intervention linked to increased complication risks.

Conclusions:

• Acute esophageal necrosis is a rare disease with uncertain etiology and management strategies.
• While interventions for AEN have risen, patient outcomes have not improved, indicating a need for further investigation.
• Additional research is crucial to determine the most effective treatments for this potentially fatal esophageal condition.