Nonneoplastic disorders
Black esophagus

Author: Elliot Weisenberg, M.D. (see Authors page)

Revised: 15 January 2018, last major update November 2012

Copyright: (c) 2003-2018,, Inc.

PubMed Search: Black esophagus[TI]

Cite this page: Weisenberg, E. Black esophagus. website. Accessed November 21st, 2018.
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