Black Esophagus Due to Acute Necrosis

A 72-year-old man with pancreatic cancer presented coffee-ground emesis for 2 days. Computed tomography of abdomen oral contrast showed gastric distention, transition point at level the bulb and large volume ascites. Endoscopy severe diffuse exudative esophagitis involving most esophagus areas black discoloration mid distal edematous (Figures B). infiltrating mass, consistent known cancer, was noted in second part duodenum obstructing duodenal lumen C). Patient kept nil per orally started on intravenous pantoprazole hydration. Acute esophageal necrosis (AEN), also as esophagus, is a rare clinical condition prevalence 0.001% to 0.2%. It diagnosed endoscopically characterized by circumferential necrotic mucosa that universally affects stops gastroesophageal junction D). more common men, mortality ranges from 13% 35%. Distal watershed area, which explains typical location AEN. Pathogenesis involves 2-hit hypothesis (esophageal ischemia outlet obstruction). AEN associated malignancy, obstruction, prolonged vomiting. Although rare, early diagnosis treatment increase chances survival.