Abstract
Acute esophageal necrosis, commonly named to as black esophagus; is a rare clinical entity arising from combination of ischemic insult seen in hemodynamic compromise and low-flow states; arise in the setting of multiorgan dysfunction, hypoperfusion, vasculopathy, sepsis, diabetic ketoacidosis, alcohol intoxication, thromboembolic phenomena and malignancy. Clinical presentation is remarkable for upper gastrointestinal bleeding. The endoscopic findings are characterized by the development of diffuse circumferential black mucosal discoloration in the distal esophagus that may extend proximally to involve variable length of the organ. Biopsy is recommended but no required for the diagnosis. Histologically the absence of viable squamous epithelium and necrosis of esophageal mucosa are present. The treatment is directed to correcting the coexisting clinical conditions and restoring hemodynamic stability. Complications include perforation with mediastinal infection and esophageal stenosis. The mortality rate is of 32% and is usually related to the underlying diseases.
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