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Updated: Aug 5, 2025

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Published on: April 17, 2020
Comprehensive Review: Acute Esophageal Necrosis in the Setting of Gastric Volvulus
Moniyka Sachar1, Erick Arguetta2, Grigoriy E Gurvits3
1Department of Medicine, New York University Langone Medical Center, 247 E 28Th Street, New York, NY, 10016, USA. moniyka.sachar@nyulangone.org.
Background And Aims:
Acute esophageal necrosis (AEN) in the setting of gastric volvulus is a rare condition with only a handful of cases reported. Volvulus may contribute to AEN by limiting tissue perfusion and promoting massive reflux of gastric contents on compromised esophageal mucosa.
Methods:
We reviewed 225 original articles, literature reviews, case series, brief reports, case reports, and discuss six total cases of co-occurring esophageal necrosis and gastric volvulus.
Results And Conclusions:
We present the first comprehensive analysis of all reported cases in the literature to date and formulate management strategies for the co-occurrence of AEN and volvulus. Management of AEN should be directed at correcting underlying medical conditions, providing hemodynamic support, initiating nil-per-os restriction, and administering high-dose proton pump inhibitor therapy. Surgical intervention is typically reserved for cases of esophageal perforation with mediastinitis and abscess formation.
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