Acute esophageal necrosis, sometimes known as Black esophagus or esophageal stroke, is a rare entity characterized by patchy or diffuse circumferential black pigmentation of the esophageal mucosa from ischemic necrosis.
It is classically characterized by a striking endoscopic image of diffuse, circumferential, black-appearing, distal esophageal mucosa on oesophago-gastroduodenoscopy (EGD) that stops abruptly at the gastro-esophageal junction.
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Epidemiology
It reported incidence is difficult to accurately determine but from total reported number of cases in the current literature of <150 1. There is a greater male predilection 5.
Pathology
It can have a multifactorial etiology.
Location - distribution
The distal third of the esophagus is thought to be most commonly affected (97% of cases) due to poor vascularity.
Treatment and prognosis
It generally carries a poor prognosis 3,5 and present with life-threatening upper gastrointestinal hemorrhage. Most cases are conservatively managed 3. It may lead to esophageal perforation.
History and etymology
It is thought to have been been first reported in 1990 and was then classified as a separate syndrome in 2007.
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