Journal of Investigative Medicine High Impact Case Reports (Aug 2024)

A View in the Dark: Two Cases of Acute Esophageal Necrosis in the Setting of Diabetic Ketoacidosis

  • Lefika Bathobakae MD, MPH,
  • Rammy Bashir MD, MSc,
  • Dhruv Patel DO,
  • Tyler Wilkinson MD, MSc,
  • Nader Mekheal MD,
  • Gabriel Melki MD,
  • Yana Cavanagh MD,
  • Walid Baddoura MD

DOI
https://doi.org/10.1177/23247096241269864
Journal volume & issue
Vol. 12

Abstract

Read online

Acute esophageal necrosis (AEN), also known as Gurvits syndrome, is a rare and potentially life-threatening condition characterized by necrosis of the esophageal mucosa. Acute esophageal necrosis is often associated with critical conditions, such as myocardial infarction, diabetic ketoacidosis (DKA), coronavirus disease 2019 (COVID-19) infection, or post-surgical complications. Patients typically present with nausea, hematemesis, acute dysphagia, and melena. Given its high mortality rate, prompt detection with upper endoscopy and early initiation of treatment are crucial. Most cases of Gurvits syndrome are managed conservatively using intravenous fluids, proton pump inhibitors, and antibiotics. Herein, we present a case series of AEN in the setting of DKA. Both patients received supportive care and were discharged in a stable condition.