Conditions increasing the risk for AEN:
(1) advanced age
(2) male gender
(3) diabetes mellitus
(4) malnutrition
(5) renal insufficiency
(6) atherosclerotic cardiovascular disease
(7) solid organ or hematologic malignancy
(8) hypercoagulability
(9) vasculopathy, including polyarteritis nodosa
Conditions that may precipitate necrosis:
(1) multi-organ failure
(2) hypotension/hypoperfusion
(3) sepsis
(4) diabetic ketoacidosis
(5) alcohol intoxication
(6) gastric volvulus
(7) thromboembolic event
(8) trauma, especially if there is trauma to the thoracic aorta
(9) acute esophagitis (bacterial, viral, fungal)
(10) acute liver disease
(11) upper abdominal surgery
(12) acute pancreatitis
(13) acute immune reaction (hypersensitivity, erythema multiforme, Stevens Johnson syndrome)
The diagnosis of acute esophageal necrosis should be considered in a patient with unexplained upper gastrointestinal bleeding and one or more comorbidities, especially if the onset is after a precipitating event.
