{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T01:57:27Z","timestamp":1783389447083,"version":"3.54.6"},"reference-count":10,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,3,1]],"date-time":"2021-03-01T00:00:00Z","timestamp":1614556800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JGH Open"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Acute esophageal necrosis (AEN) is a rare presentation of severe esophageal injury. The optimal long\u2010term management of complications related to AEN, particularly stricture formation, are not well defined. We report a case of AEN in a patient who presented with diabetic ketoacidosis (DKA) and had dysphagia due to refractory stricture formation after mucosal healing occurred. A 62\u2010year\u2010old male with diabetes mellitus presented with altered mental status. He was admitted for hypovolemic shock secondary to DKA and treated with vasopressors, fluid resuscitation, and insulin. After resolution of DKA, he reported persistent dysphagia. Upper endoscopy showed circumferential black mucosal discoloration throughout the entire esophagus that spared the gastroesophageal junction. He was diagnosed with AEN and was continued on a proton pump inhibitor and sucralfate with improvement in symptoms. Repeat endoscopy 4\u2009weeks later showed a 10\u2010cm benign\u2010appearing stricture in the mid esophagus. He underwent dilation with temporary symptomatic relief; however, recurrence in symptoms has thus far necessitated a total of 10 repeat upper endoscopies, including repeat dilations along with local steroid injection therapy. AEN is a rare presentation of severe esophageal injury and is typically associated with severe hemodynamic compromise. Although most cases resolve with supportive care and mucosal healing, there is little information regarding prognosis and optimal management of complications, such as refractory esophageal strictures. We describe a case of AEN complicated by refractory symptomatic esophageal stricture despite several dilations and intralesional steroid injections and discuss our approach to treatment.<\/jats:p>","DOI":"10.1002\/jgh3.12520","type":"journal-article","created":{"date-parts":[[2021,3,1]],"date-time":"2021-03-01T12:24:28Z","timestamp":1614601468000},"page":"528-530","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Acute esophageal necrosis complicated by refractory stricture formation"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2530-5885","authenticated-orcid":false,"given":"Sunny","family":"Sandhu","sequence":"first","affiliation":[{"name":"Department of Internal Medicine University of California  Fresno California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology University of California  Fresno California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devang","family":"Prajapati","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology University of California  Fresno California USA"},{"name":"Department of Gastroenterology and Hepatology VA Central California Healthcare System  Fresno California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3]]},"reference":[{"key":"e_1_2_4_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.20.4.581"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(90)90844-Q"},{"key":"e_1_2_4_4_1","first-page":"529","article-title":"Diagnosis and management of acute esophageal necrosis","volume":"32","author":"Dias E","year":"2019","journal-title":"Ann. Gastroenterol."},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-006-1974-z"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000504434"},{"key":"e_1_2_4_7_1","volume-title":"Surgical Treatment: Evidence\u2010Based and Problem\u2010Oriented","author":"Schlachta CM","year":"2001"},{"key":"e_1_2_4_8_1","doi-asserted-by":"publisher","DOI":"10.5001\/omj.2014.79"},{"key":"e_1_2_4_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11938-014-0043-6"},{"key":"e_1_2_4_10_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.11.040"},{"key":"e_1_2_4_11_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.11.7608"}],"container-title":["JGH Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jgh3.12520","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jgh3.12520","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jgh3.12520","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T15:56:42Z","timestamp":1693411002000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jgh3.12520"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3]]},"references-count":10,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,4]]}},"alternative-id":["10.1002\/jgh3.12520"],"URL":"https:\/\/doi.org\/10.1002\/jgh3.12520","archive":["Portico"],"relation":{},"ISSN":["2397-9070","2397-9070"],"issn-type":[{"value":"2397-9070","type":"print"},{"value":"2397-9070","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3]]},"assertion":[{"value":"2021-01-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-02-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}