Acute Esophageal Necrosis Associated with Alcoholic Ketoacidosis A Case Report

Acute esophageal necrosis (AEN) is a rare condition associated with ischemia of the esophagus, corrosive injury by gastric fluids and reduced mucosal defense. It is also referred to as "Black Esophagus" or "Gurvit's syndrome". Its clinical presentation is most notable for upper gastrointestinal bleeding with signs and symptoms such as abdominal or epigastric pain, nausea, vomiting, dysphagia and fever. AEN is diagnosed via esophagogastroduodenoscopy, where the cardinal finding is a circumferential black discoloration of the esophagus, usually most pronounced in the distal esophagus. The lesion usually stops abruptly at the gastroesophageal junction. AEN is usually seen in older men with multiple comorbidities (eg, cardiovascular disease, diabetes mellitus) and follows a triggering event (eg, sepsis, diabetic ketoacidosis). We describe the case of a 28-year-old man presenting with acute esophageal necrosis associated with alcoholic ketoacidosis after excessive alcohol consumption, prolonged starvation and self-reported increased intake of venlafaxine and quetiapine.