Acute oesophageal necrosis, black oesophagus (BE) or Gurvits syndrome (GS) is a rare form of severe oesophagitis appearing as a striking circumferential discolouration of distal mucosa with various proximal extensions abruptly terminating at the gastro-oesophageal junction. It is most commonly associated with acute exacerbations of medical comorbidities, while associations with altered gut anatomy are rare. We present a unique constellation of BE, Cameron ulcers (CU), and gastric volvulus from a large paraesophageal hiatal hernia. Our patient recently recovered from COVID-19 and was malnourished and frail, while the expanding paraesophageal hiatal hernia turned into an acute organoaxial gastric volvulus with accompanying outlet obstruction. In low-flow post-COVID coagulopathic states, compensatory mechanisms may lack against gastric stunning and sudden massive reflux on the oesophagus. We additionally performed a systematic review and discovered additional cases with coexistent volvulus and paraesophageal hernia, although there are no previous reports of BE with CU, which makes this study the first.

中文翻译：

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黑色食道、倒置胃和卡梅伦病变：大食管裂孔疝的级联效应

急性食管坏死、黑食管 (BE) 或古尔维茨综合征 (GS) 是一种罕见的严重食管炎，表现为远端粘膜明显的圆周变色，并伴有各种近端延伸突然终止于胃食管交界处。它最常与医学合并症的急性加重有关，而与肠道解剖结构改变的关联很少。我们提出了一系列独特的 BE、卡梅伦溃疡 (CU) 和来自大型食管旁裂孔疝的胃扭转。我们的患者最近从 COVID-19 中康复，营养不良且虚弱，而不断扩大的食管旁裂孔疝变成了急性器轴性胃扭转，并伴有出口梗阻。在新冠肺炎后的低流量凝血障碍状态下，可能缺乏针对胃击晕和食道突然大量反流的补偿机制。我们还进行了系统回顾，发现了更多同时存在肠扭转和食管旁疝的病例，尽管之前没有关于 BE 合并 CU 的报道，这使得这项研究成为第一项研究。