Acute esophageal necrosis: a case report and review

Acute esophageal necrosis, commonly referred to as “black esophagus” or “acute necrotizing esophagitis”, is a rare clinical disorder with an unclear etiology. The definition excludes patients with a history of recent caustic ingestion. Oesophageal necrosis can be diagnosed at endoscopy by the presence of black necroting appearing oesophagus. Contrary to the caustic oesophagitis whose treatment is often surgical, treatment of the acute necrositing oesophagitis is primarily medical. The prognosis for patients who develop acute necrotizing oesophagitis is generally poor. We report a new case of acute necrotizing oesophagitis and undertook a literature review of this rare diagnosis.

A case of acute oesophageal necrosis (AEN) in a hypothermic patient. The grave prognosis of the black oesophagus

Acute oesophageal necrosis, also known as black oesophagus, is a rare, and potentially lethal syndrome which is often diagnosed incidentally during upper endoscopy for evaluation of upper gastrointestinal bleed. It is characterised by diffuse circumferential black mucosal discolouration in the distal oesophagus secondary to necrosis that may extend proximally to involve variable length of the oesophagus. One theory of pathogenesis is that the relatively low perfusion state in the distal areas of the oesophagus makes it susceptible to mucosal injury. We present a case of acute oesophageal necrosis in a 62year-old lady with history of alcoholic cirrhosis who presented with haematemesis and severe hypothermia, and was eventually found to have acute oesophageal necrosis.