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

Figure 1 A 55-year-old woman in generally poor condition was admitted with life-threatening gastrointestinal bleeding. At endoscopy a dark diffuse black-greenish appearance was seen in the middle part of the esophagus. The necrotic esophageal mucosa was covered by pseudomembrane (asterisk) that could easily be removed by forceps.

Figure 2 Mucosal and submucosal necrosis was found at histology (hematoxylin-eosin stain). Nonspecific granuloma was seen at the centre (asterisk).

Figure 3 Appearance at control endoscopy after 3 months. Re-epithelialization had taken place in the proximal esophagus and circular ulceration covered with white fibrin was seen in the distal esophagus.

Figure 4 A 47-year-old man with relapse of cancer of the oral cavity. The patient was referred for percutaneous endoscopic gastrostomy (PEG) tube placement and an asymptomatic black esophagus was found.