Korean J Intern Med.  2014 May;29(3):379-382. 10.3904/kjim.2014.29.3.379.

Acute esophageal necrosis occurring in a patient undergoing percutaneous coronary intervention

• Kwon HJ
• Park SH
• Ahn JH
• Lee TH
• Lee CK

• KMID: 1792065
• DOI: http://doi.org/10.3904/kjim.2014.29.3.379

Abstract

Acute esophageal necrosis is uncommon in the literature. Its etiology is unknown, although cardiovascular disease, hemodynamic compromise, gastric outlet obstruction, alcohol ingestion, hypoxemia, hypercoagulable state, infection, and trauma have all been suggested as possible causes. A 67-year-old female underwent a coronary angiography (CAG) for evaluation of chest pain. CAG findings showed coronary three-vessel disease. We planned percutaneous coronary intervention (PCI). Coronary arterial dissection during the PCI led to sudden hypotension. Six hours after the index procedure, the patient experienced a large amount of hematemesis. Emergency gastrofibroscopy was performed and showed mucosal necrosis with a huge adherent blood clot in the esophagus. After conservative treatment for 3 months, the esophageal lesion was completely improved. She was diagnosed with acute esophageal necrosis. We report herein a case of acute esophageal necrosis occurring in a patient undergoing percutaneous coronary intervention.

Keyword

Esophagus; Cardiovascular diseases; Necrosis; Shock; Coronary artery diseases

MeSH Terms

Acute Disease
Aged
Coronary Angiography
Coronary Stenosis/diagnosis/physiopathology/*therapy
Esophageal Diseases/diagnosis/drug therapy/*etiology
Esophagoscopy
Esophagus/drug effects/*pathology
Female
Hemodynamics
Humans
Necrosis
Percutaneous Coronary Intervention/*adverse effects
Predictive Value of Tests
Proton Pump Inhibitors/therapeutic use
Risk Factors
Time Factors
Treatment Outcome
Ultrasonography, Interventional
Wound Healing
Proton Pump Inhibitors