Acute Esophageal Necrosis (Black Esophagus): Endoscopic and Histopathologic Appearance

Acute esophageal necrosis: a rare syndrome

“…However, one report noted an asymptomatic black esophagus in a cancer patient during a percutaneous endoscopic gastrostomy tube placement. 11 Diagnosis of AEN is made endoscopically in an appropriate clinical setting by observing a diffusely black esophageal mucosa, preferentially affecting the distal portion of the organ, although each segment can be separately involved or the appearance can be rather panesophageal. Black esophagus should generally end abruptly at the Z-line, 9 but an infectious case was reported where it extended into the cardia of the stomach.…”

A ‘black stomach’ due to ingestion of anhydrous calcium chloride

“…The term ‘black oesophagus’ is the uncommon endoscopic finding of extensive black discolouration of the oesophageal mucosa, usually from acute oesophageal necrosis 1. Acute oesophagogastric necrosis is a rare clinical entity arising from a combination of ischaemic insult seen in low-flow states and corrosive injury 2 3. Although there are some reports of acute gastric necrosis in the literature, we did not found any that described the endoscopic appearance of a ‘black stomach’.…”

Erratum: Acute Esophageal Necrosis: A Case of Black Esophagus Associated with Bismuth Subsalicylate Ingestion

“…Histopathology often shows mucosal and submucosal necrosis with heavy leukocyte infiltration, as seen in our patient, though biopsy is not required for diagnosis. 7 Management is conservative, but patients require close monitoring due to the risk of complications such as superimposed infections, stenosis, strictures, and perforations. Mortality can reach as high as 32% (often in cases presenting with other comorbidities), but mortality specific to AEN is around 6%.…”