Black esophagus: a case report.

INTRODUCTION: Acute esophageal necrosis, also known as black esophagus, is a rare digestive complication, frequently manifested by an upper gastrointestinal hemorrhage and occurs in patients with comorbidities. AIM: To report the case of a patient with a black esophagus revealed by an upper gastrointestinal hemorrhage. OBSERVATION: A 72-year-old patient with a history of diabetes mellitus, hypertension and ischemic heart disease was hospitalized in surgical intensive care unit for hemorrhagic shock induced by cholecystectomy. On the 7th postoperative day, the patient developed acute hematemesis. Gastroscopy showed circumferential necrosis, localized in the middle and lower third of the esophagus and stopped abruptly at the gastroesophageal junction. Gastric mucosa was strictly normal. The bulb and the first part of duodenum showed multiple superficial ulcers without signs of recent hemorrhage. The patient was placed on absolute diet and total parenteral nutrition associated with high-dose intravenous proton pump inhibitor. Second-look gastroscopy, performed six days later, showed a significant improvement in esophageal lesions. The evolution was marked by the occurrence of pneumonia complicated by septic shock which caused patient's death. CONCLUSION: Black esophagus is a rare pathology of multifactorial etiology. Treatment is based on proton pump inhibitors in combination with resuscitation measures to control comorbidities. Mortality remains high due to the seriousness of comorbid disease states often associated with this condition.

Death by aortoesophageal fistula due to disseminated tuberculosis: a case study.

Tuberculosis remains a serious public health problem worldwide, especially in Korea. Although tuberculosis is generally considered a non-fatal chronic disease, deaths have occurred. In this case study, a 68-year-old man was admitted to the hospital with dyspepsia, vomiting, and abdominal pain. Nine hours later, he suffered severe hematemesis and died despite cardiopulmonary resuscitation. A medico-legal autopsy was performed and an external examination revealed no external injuries. However, an internal examination revealed an aortoesophageal fistula and a large amount of blood in the stomach. A histologic examination confirmed tuberculous mediastinitis with disseminated tuberculosis involving multiple organs, including the heart, lungs, liver, kidneys, and spleen. Both an aortoesophageal fistula and sudden death due to tuberculosis infection are rare. This paper reports the case of a fatal aortoesophageal fistula associated with disseminated tuberculosis.

The role of surgery in a case of diffuse mucormycosis with haematemesis and gastric necrosis.

Mucormycosis is a life threatening condition caused by invasion of fungi of the order Mucorales. Gastrointestinal invasion is very rare and often lethal, particularly in disseminated mucormycosis. We present the case of a 26-year-old woman from North Africa with type 2 diabetes who, after a cholecystectomy, developed unexplained septic shock and haematemesis due to gastric necrosis. Computed tomography (CT) revealed a disseminated fungal invasion of the lungs, kidney and paranasal sinuses. A gastrectomy and subsequent amphotericin B treatment resolved her condition. The number of patients with mucormycosis is increasing. Early diagnosis of high risk patients with CT and biopsies from which fungi are directly isolated must be followed by surgery and systemic amphotericin B infusion.

[Helicobacter pylori infection in childhood revealed by hematemesis: endoscopic and pathologic patterns]. / L'infection a Helicobacter pylori chez l'enfant revelee par une hemorragie digestive: aspects endoscopiques et histologiques la Tunisie.

BACKGROUND: Helicobacter pylori infection frequency in hematemesis was scarcely studied. AIM: to asses the frequency of this infection in children with upper gastrointestinal bleeding and to study the endoscopic and histological features. METHODS: It is a retrospective study including 180 children who underwent an endoscopy for upper gastrointestinal bleeding. Our population was divided in two groups. The group 1 (n=95) has performed gastric biopsy. The group 2 (n=95) has'nt performed gastric biopsy. For each group, we studied the personal and familial history of gastroenterologic disease, the hospital where they come from, the importance of bleeding, the drug intake effecting the gastric mucosa, the endoscopic and histological features. RESULTS: The helicobacter pylori infection was present in 48% of the children. The mean age of these children was 99.8 +/- 42.1 months versus 95.7 +/- 44 months (p=0.13) The comparison of the two groups according to Hp infection, and the others parameters don't found any differences. All the infected children have chronic gastritis 40/40 versus 13/44 in the non infected children (p>10 -6). CONCLUSION: The frequency of Hp infection was high in this group of patients with upper gastrointestinal bleeding. It was probably underestimated because the investigation was not complete. We emphasize that Hp infection has to be investigated and systematically eradicated whenever there were severe symptoms like hematemesis indicating therefore organic disease.

[Two cases of enteritis with bacteremia due to Campylobacter jejuni]. / Dos casos de enteritis con bacteriemia por Campylobacter jejuni.

Campylobacter is an important agent of illness in human beings. Bacteremia occurs principally in the immunocompromissed host and is frequently due to C. fetus. Nevertheless bacteremia also has been observed in patients with enteritis due to C. jejuni. We refer two cases of patients with severe enteritis and bacteremia, both of them with immunosupressive concomitant diseases such as nephrotic syndrome and chronic cirrotic hepatopathy. Both patients presented hemathemesis.

Dos casos de enteritis con bacteriemia por Campylobacter jejuni / Two cases of enteritis with bacteremia due to Campylobacter jejuni

Campylobacter es un importante agente causante de enfermedad en el ser humano en nuestro medio. Los casos de bacteriemia ocurren principalmente en pacientes inmunosuprimidos y sondebidos frecuentemente a C. fetus. Sin embargo la bacteriemia es un episodio que también se ha observado enpacientes con enteritis por C. jejuni. Referimos dos pacientes con enteritis grave y bacteriemia, ambos con enfermedades concomitantes compatibles con inmunodepresión: uno con síndrome nefrótico de larga data y otro con hepatopatía crónica con cirrosis. Destacamos que los dos casos presentaron hematemesis y uno de ellos,enterorragia. Sugerimos prestar atención a la coloración de Gram durante el subcultivo de los caldos conhemocultivos, en busca de formas características de esta especie, y en ese caso emplear medios de cultivo enmicroaerofilia a 37 y 42 °C

Campylobacter is an importantagent of illness in human beings. Bacteremia occurs principally in the immunocompromissed host and is frequently due to C. fetus. Nevertheless bacteremia also has been observed in patients with enteritis due to C. jejuni. We refer two cases of patients with severe enteritis and bacteremia, both of them with immunosupressive concomitant diseases such as nephrotic syndrome and chronic cirrotic hepatopathy. Both patients presented hemathemesis

Dos casos de enteritis con bacteriemia por Campylobacter jejuni / Two cases of enteritis with bacteremia due to Campylobacter jejuni

Campylobacter es un importante agente causante de enfermedad en el ser humano en nuestro medio. Los casos de bacteriemia ocurren principalmente en pacientes inmunosuprimidos y sondebidos frecuentemente a C. fetus. Sin embargo la bacteriemia es un episodio que también se ha observado enpacientes con enteritis por C. jejuni. Referimos dos pacientes con enteritis grave y bacteriemia, ambos con enfermedades concomitantes compatibles con inmunodepresión: uno con síndrome nefrótico de larga data y otro con hepatopatía crónica con cirrosis. Destacamos que los dos casos presentaron hematemesis y uno de ellos,enterorragia. Sugerimos prestar atención a la coloración de Gram durante el subcultivo de los caldos conhemocultivos, en busca de formas características de esta especie, y en ese caso emplear medios de cultivo enmicroaerofilia a 37 y 42 ºC (AU)

Campylobacter is an importantagent of illness in human beings. Bacteremia occurs principally in the immunocompromissed host and is frequently due to C. fetus. Nevertheless bacteremia also has been observed in patients with enteritis due to C. jejuni. We refer two cases of patients with severe enteritis and bacteremia, both of them with immunosupressive concomitant diseases such as nephrotic syndrome and chronic cirrotic hepatopathy. Both patients presented hemathemesis (AU)

Dos casos de enteritis con bacteriemia por Campylobacter jejuni / Two cases of enteritis with bacteremia due to Campylobacter jejuni

Campylobacter es un importante agente causante de enfermedad en el ser humano en nuestro medio. Los casos de bacteriemia ocurren principalmente en pacientes inmunosuprimidos y sondebidos frecuentemente a C. fetus. Sin embargo la bacteriemia es un episodio que también se ha observado enpacientes con enteritis por C. jejuni. Referimos dos pacientes con enteritis grave y bacteriemia, ambos con enfermedades concomitantes compatibles con inmunodepresión: uno con síndrome nefrótico de larga data y otro con hepatopatía crónica con cirrosis. Destacamos que los dos casos presentaron hematemesis y uno de ellos,enterorragia. Sugerimos prestar atención a la coloración de Gram durante el subcultivo de los caldos conhemocultivos, en busca de formas características de esta especie, y en ese caso emplear medios de cultivo enmicroaerofilia a 37 y 42 ºC (AU)

Campylobacter is an importantagent of illness in human beings. Bacteremia occurs principally in the immunocompromissed host and is frequently due to C. fetus. Nevertheless bacteremia also has been observed in patients with enteritis due to C. jejuni. We refer two cases of patients with severe enteritis and bacteremia, both of them with immunosupressive concomitant diseases such as nephrotic syndrome and chronic cirrotic hepatopathy. Both patients presented hemathemesis (AU)

Isolated gastric tuberculosis presenting as massive hematemesis: report of a case.

Tuberculous involvement of the stomach is rare. We report herein the unusual case of a 25-year-old man in whom a benign gastric ulcer was found along the lesser curvature after he presented with massive upper gastrointestinal bleeding. Histopathological examination helped to confirm a diagnosis of tuberculosis. The granulomas typical of tuberculosis were caseation with epithelioid and giant cells. The patient was successfully treated by a combination of appropriate surgical therapy and prompt institution of antituberculosis medication.

Gastrointestinal bleeding with influenza virus.

Seven children who presented during the influenza A(H1N1) epidemic of 1988 are described. After a typical influenzal illness, they developed haematemesis of varying severity. Endoscopy revealed haemorrhagic gastritis. Laboratory evidence of influenza A(H1N1) virus infection was present. Two children died as a result of their illness. The association of virus and gastrointestinal haemorrhage is explored.