Acute oesophageal necrosis: single centre experience

Acute oesophageal necrosis (AEN) is a rare but important cause of upper gastrointestinal bleeding (UGIB). The prognosis is poor and related to the presence of concomitant diseases. In this study, we aimed to evaluate the outcomes of patients with AEN.

Patients who were admitted to the endoscopy unit of Adana City Training and Research Hospital between January 2015 and July 2025 who were diagnosed with AEN were included in the study. Patient files, past medical records, endoscopic findings and outcomes were evaluated retrospectively.

AEN was seen in 29 (0.12%) of the 24,805 endoscopies. The mean patient age was 66.2 ± 18 (24-92) years, and 15 (51.7%) patients were female. Most patients had malignancies, diabetes mellitus, hypertension, or coronary artery disease. The most common presentations were haematemesis and melena. In terms of oesophageal involvement, pan oesophageal necrosis and middle oesophageal necrosis were the most common forms of the disease. Thirteen (44.8%) patients died during hospitalization. Most mortality was caused by accompanying diseases, particularly sepsis. Only three patients died directly due to AEN.

AEN should initially be considered a cause of UGIB in elderly patients with comorbid diseases. The outcomes of patients with AEN are poor, mostly due to older age and comorbid conditions such as malignancy, diabetes mellitus, heart disease, and cirrhosis. To gain a better understanding of AEN, prospective and multicentre studies with larger patient populations are needed.