Analysis of the pathogenesis of acute necrotizing esophagitis (black esophagus): A report of three autopsy cases
Analysis of the pathogenesis of acute necrotizing esophagitis (black esophagus): A report of three autopsy cases
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急性坏死性食管炎（黑食管）发病机制分析：尸检三例报告
DOI：
10.1016/j.jflm.2023.102515
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发表时间：
2023
影响因子：
1.5
通讯作者：
Nakao KI
中科院分区：
文献类型：
--
作者：
Sano H;Kibayashi K;Shimada R;Nakao KI
急性坏死性食管炎是一种罕见的疾病，其特征是食管粘膜变黑。我们描述了三个ANE尸检病例，也被称为黑色食管。黑色变色仅限于食管粘膜而非胃粘膜。棕色色素沉着和急性炎症的组织学检查结果导致ANE诊断。在所有情况下，直接死亡原因都被证明是ANE。在这3例病例中，1例有高血压、糖尿病和多发性脑梗死，另1例有酒精中毒，而另1例患者的既往疾病未知。所有三名患者的胃粘膜上均发现点状出血，这是终末低温的结果。在1例病例中，死亡前观察到频繁呕吐。检测到血液酒精（患者在死亡前立即饮酒），并认为ANE的发作发生在死亡前几小时。研究结果表明，ANE发生在死亡前不久，在脑血管疾病或酒精中毒的情况下，伴有频繁的呕吐和终末体温过低。
Acute necrotizing esophagitis (ANE) is a rare condition characterized by black discoloration of the esophageal mucosa. We describe three autopsy cases of ANE, also known as black esophagus. The black discoloration was confined to the esophageal mucosa rather than to the gastric mucosa. The histological findings of brown pigmentation and acute inflammation led to an ANE diagnosis. The immediate cause of death was certified as ANE in all cases. In the three cases, one had hypertension, diabetes, and multiple cerebral infarctions, another had alcoholism, whereas the pre-existing condition was unknown in the remaining patient. Petechial hemorrhages were found on the gastric mucosa of all three patients as a finding of terminal hypothermia. In one case, frequent vomiting was observed prior to death. Blood alcohol was detected (the patient had been drinking immediately prior to death), and the onset of ANE was considered to have occurred several hours before death. The findings indicate that ANE occurs shortly before death in combination with frequent vomiting and terminal hypothermia in the setting of cerebrovascular disease or alcoholism.