Nonneoplastic disorders
Black esophagus

Topic Completed: 1 November 2012

Revised: 9 September 2019

Copyright: 2003-2019,, Inc.

PubMed Search: Black esophagus[TI]

Elliot Weisenberg, M.D.
Page views in 2019: 517
Page views in 2020 to date: 151
Cite this page: Weisenberg E. Black esophagus. website. Accessed April 1st, 2020.
Definition / general
  • Also called acute esophageal necrosis
  • Somewhat rare (~100 cases reported, 0.2% of endoscopies); endoscopic finding of black, diffusely necrotic esophageal mucosa, primarily in distal third
Clinical features
  • Present with GI bleeding or cardiovascular shock / events
Case reports
Clinical images

Images hosted on other servers:

Perforated esophagus (1) with intraluminal hematoma (2)

Extensive esophageal perforation with distal perforation

Gross description
  • Darkly pigmented esophageal mucosa with ulcerations
Microscopic (histologic) description
  • Severe acute inflammation with mucosal necrosis; hemosiderin and siderophages but no melanin
  • Necrosis may extend into muscularis propria and be overlooked at autopsy (APMIS 2003;111:591)
Microscopic (histologic) images

Images hosted on other servers:

Extensive ulceration and necrosis

Differential diagnosis
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