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The Black Esophagus: A Rare Case Presentation.

Cureus

December 2024

Gastroenterology and Hepatology, Saint Peter's University Hospital, New Brunswick, USA.

Acute esophageal necrosis (AEN), also known as black esophagus or Gurvits syndrome, is an uncommon endoscopic finding characterized by diffuse, circumferential, black discoloration of the esophagus that terminates at the gastroesophageal junction. The incidence of AEN has been reported to be 0-0.2% in autopsy series and up to 0.

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Background And Study Aim: We previously reported the utility of endoscopic band ligation (EBL) in weight loss in a female patient with obesity. This study aimed to evaluate the safety of weight loss using EBL in a larger cohort.

Patients And Methods: This prospective cohort study included 13 female patients aged ≥ 18 years with a body mass index of ≥ 30 kg/m who were unwilling to undergo bariatric surgery.

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Article Synopsis
  • Acute esophageal necrosis (AEN) is a rare and serious condition marked by black discoloration in the esophagus, often triggered by major stressors like trauma or surgeries, with a mortality rate up to 32%.
  • Patients with AEN typically have risk factors such as diabetes, hypertension, and kidney disease, but it can also occur in healthy individuals after surgery.
  • Early diagnosis through upper endoscopy and supportive care is crucial to manage AEN effectively and reduce the risk of severe complications.
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Aplastic Anemia With Non-Occlusive Mesenteric Ischemia.

Cureus

October 2024

Endocrinology and Diabetes, Hinchingbrooke Hospital, Huntingdon, GBR.

This case highlights the multifaceted challenges of managing aplastic anemia, especially when complicated by non-occlusive mesenteric ischemia (NOMI). The patient's clinical course underscores the importance of a conservative, multidisciplinary approach in balancing the risks of invasive procedures with the need for effective diagnostics and treatment. Recognizing the risks associated with pancytopenia, including life-threatening bleeding and infections, is critical in managing such patients.

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We report a case of hepatoblastoma in a 26-year-old man with a background of type 2 diabetes mellitus and untreated hepatitis B, initially presenting with hematemesis and a recent diagnosis of hepatocellular carcinoma on computed tomography scan from a different hospital and recent referral to hospice. On presentation to our hospital, given atypical presentation for hepatocellular carcinoma, histological examination was made, revealing hepatoblastoma. Treatment included chemotherapy and management of hepatitis B, although complicated by chemotherapy-induced cytopenias and tumor progression, ultimately losing the patient to follow-up after 2 years.

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