{
  "abstract": "Acute oesophageal necrosis (AEN), also known as ‘black esophagus’, is a rare but severe condition characterised by diffuse ischaemic necrosis of oesophageal tissue. It is most commonly seen in older adult men with multiple comorbidities and presents with upper gastrointestinal bleeding, haemodynamic compromise and non-specific symptoms, such as epigastric pain or dysphagia. Endoscopy is diagnostic, revealing black, friable mucosa that is often associated with ulceration or clot burden. The pathogenesis of AEN is multifactorial and involves ischaemic injury, impaired mucosal defences and corrosive exposure to gastric contents. Initial management includes haemodynamic stabilisation, nil per os status, intravenous proton pump inhibitors and nutritional support. Infections and underlying triggers such as diabetic ketoacidosis or alcohol withdrawal must be aggressively addressed. Endoscopic interventions, including epinephrine injection, covered self-expanding metal stents and endoscopic vacuum therapy, are increasingly used in complicated cases involving bleeding, perforation or fistula formation. Surgical options, oesophagectomy or bypass procedures, are reserved for refractory or life-threatening complications, such as transmural necrosis, mediastinitis or complex strictures. Given the limited evidence base and absence of standardised guidelines, treatment decisions are largely individualised and based on small series and expert opinion. This review summarises current diagnostic and therapeutic strategies for AEN and proposes a pragmatic algorithm for multidisciplinary management. Future prospective studies are needed to guide timing, modality selection and risk stratification in this life-threatening condition.",
  "authors": [
    {
      "affiliations": [
        "Internal Medicine, St Joseph’s University Medical Center, Paterson, New Jersey, USA"
      ],
      "name": "Lefika Bathobakae"
    },
    {
      "affiliations": [
        "Internal Medicine, Norwalk Hospital, Norwalk, Connecticut, USA"
      ],
      "name": "Rammy Bashir"
    },
    {
      "affiliations": [
        "Internal Medicine, St Joseph’s University Medical Center, Paterson, New Jersey, USA"
      ],
      "name": "Jorge L Lopez Cuello"
    },
    {
      "affiliations": [
        "Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA"
      ],
      "name": "Heba Farhan"
    },
    {
      "affiliations": [
        "Internal Medicine, SUNY Downstate Health Sciences University, New York, New York, USA"
      ],
      "name": "Nischal Sharma"
    },
    {
      "affiliations": [
        "Health Sciences Library, St Joseph’s University Medical Center, Paterson, New Jersey, USA"
      ],
      "name": "Jessica Escobar"
    },
    {
      "affiliations": [
        "Gastroenterology & Hepatology, St Joseph’s University Medical Center, Paterson, New Jersey, USA"
      ],
      "name": "Praneeth Bandaru"
    },
    {
      "affiliations": [
        "Gastroenterology & Hepatology, St Joseph’s University Medical Center, Paterson, New Jersey, USA"
      ],
      "name": "Yana Cavanagh"
    },
    {
      "affiliations": [
        "General, Trauma & Critical Care Surgery, St Joseph’s University Medical Center, Paterson, New Jersey, USA"
      ],
      "name": "Jideofor Aniukwu"
    }
  ],
  "title": "Supportive and endoscopic therapies for acute oesophageal necrosis: a potpourri of options",
  "uid": "674aeaf3-1b32-55f3-9805-1bc748d7f6cd"
}