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Case report
Acute oesophageal necrosis in multiple endocrine neoplasia type 1: an undescribed complication
  1. Sumona Bhattacharya1,
  2. Jenny E Blau2 and
  3. Christopher Koh3
  1. 1Digestive Disease Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
  2. 2Metabolic Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
  3. 3Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
  1. Correspondence to Dr Sumona Bhattacharya; sumona.bhattacharya{at}nih.gov

Abstract

Acute oesophageal necrosis (AEN) is a rare entity that most commonly presents as upper gastrointestinal bleeding. Complex pathophysiology may include oesophageal ischaemia as well as reflux of acidic gastric contents causing oesophageal mucosal injury. Management is supportive and directed at underlying comorbidities however prognosis is poor with complications such as oesophageal perforation, stricture and stenosis. Here we present the case of a 56-year-old man with multiple endocrine neoplasia type 1 (MEN1) and gastro-oesophageal reflux disease who developed AEN as a result of undiagnosed Zollinger-Ellison syndrome (ZES), duodenal ulcer-induced obstruction and hypotension from new-onset atrial fibrillation. AEN as the presentation of MEN1-associated ZES is an unusual presentation of this disease which clinicians, particularly endocrinologists and endoscopists, should be aware of.

  • gastroenterology
  • ulcer
  • gastro-oesophageal reflux
  • metabolic disorders

https://doi.org/10.1136/bcr-2020-238214

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    Footnotes

    • Contributors SB provided patient care and drafted the manuscript. JEB provided patient care and edited the manuscript. CK provided patient care, edited the manuscript and supervised this project.

    • Funding This study was funded by National Institute of Diabetes and Digestive and Kidney Diseases.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.