Acute Esophageal Necrosis. A Case Report.
AJTES Vol 6, No 2, July 2022
Tafaj I et al - Acute Esophageal Necrosis. A Case Report.


esophageal necrosis
gastrointestinal bleeding
black esophagus

How to Cite

Tafaj, I., Sadiku, E., Mamaj, I., Çili, Q., Cuko, L., Llazani, A., & Babameto, A. (2022). Acute Esophageal Necrosis. A Case Report. Albanian Journal of Trauma and Emergency Surgery, 6(2), 1073-1076.


Acute esophageal necrosis syndrome is a rare cause of gastrointestinal bleeding. It is characterized by a particular black coloration, mostly of the distal esophagus, which ends abruptly in the gastroesophageal junction. The hemorrhagic manifestation may be hematemesis, melena, or both of them. It is a life-threatening condition with significant differences between the two sexes.
We report a case of a 67 years old male with schizophrenia, aspiration pneumonia, and sepsis who presented with hematemesis. The endoscopic finding was a black, wide linear necrosis of the esophageal mucosa which extended from the middle esophagus to the gastroesophageal junction, compatible with acute esophageal necrosis. The esophageal lesion healed progressively at the same time with the improvement of the general health condition.
We must think of acute esophageal necrosis in critically ill male patients, in their sixth decade of life, with multiple comorbidities and gastrointestinal hemorrhage, because early recognition can help reduce the mortality of this rare syndrome.
In conclusion, we must think of acute esophageal necrosis in critically ill male patients, in their sixth decade of life, with multiple comorbidities and gastrointestinal hemorrhage. The diagnosis is made most of the time only by the characteristic endoscopic findings. Because of the gravity of this affection, the treatment must be quick and aggressive.
Tafaj I et al - Acute Esophageal Necrosis. A Case Report.


Worrell SG, Worrell, "Acute esophageal necrosis: a case series and long-term follow-up," Thoracic surgery, pp. 341-342, 2014.

Richards J, Wei R, and Anjum F "Esophageal necrosis," StatPearls, 2021, December 15 .

Goldenberg SP, Wain SL, Marignani P, "Acute necrotizing esophagitis," Gastroenterology, vol. 98(2), pp. 493-6, 1990 Feb.

Syma Iqbal, Matthew Hon Yew Leong, "Acute esophageal necrosis: a case series and its management," Journal of Surgical Case Reports, pp. 1-4, 2018; 11.

Gurvits GE, Shapsis A, Lau N, Gualtieri N, Robilotti JG, "Acute esophageal necrosis: a rare syndrome," Journal of Gastroenterology, vol. 42(1), pp. 29-38, 2007 Jan.

Dias E, Santos-Antunes J, Macedo G "Diagnosis and management of acute esophageal necrosis," Ann Gastroenterology, vol. 32(6), pp. 529-540, 2019 Nov-Dec.

Gurvitis GE, "Acute esophageal necrosis: a rare syndrome," World Journal of Gastroenterology, pp. 3219-25, 2010 Jul; 16(26).

Schizas D, Theochari NA, Mylonas KS, Kanavidis P, Spartalis E, Triantafyllou S, Economopoulos KP, Theodorou D, Liakakos T "Acute esophageal necrosis: a systemic review and pooled analysis," World J Gastrointest Surg, vol. 12(3), pp. 104-115, 2020 Mar 27.

Gurvitis GE, "Black esophagus: acute esophageal necrosis syndrome," World J Gastroenterol, vol. 16(26), pp. 3219-25, 2010 Jul 14.

Gurvits GE, Cherian K, Shami MN, Korabathina R, El-Nader EM, Rayapudi K, "Black esophagus: new insights and multicenter international experience in 2014," Dig Dis Sci , vol. Feb;60(2), pp. 444-53, 2015.

Khan H et al, "Acute esophageal necrosis: A view in the dark," Case Reports in Gastroenterology, vol. 13, pp. 25-31, 2019.

Moretó M, Ojembarrena E, Zaballa M, Tánago JG, Ibánez S "Idiopathic acute esophageal necrosis: not necessarily a terminal event," Endoscopy, vol. 25(8), pp. 534-8, 1993 Oct.

Abdullah HM, Ullah W, Abdallah M, Khan U, Hurairah A, Atiq M "Clinical presentations, management and outcomes of acute esophageal necrosis: a systemic review," Expert Rev Gastroenterol Hepatol, vol. 13(5), pp. 507-514, 2019 May.

Lacy BE, Toor A, Bensen SP, Rothstein RI, Maheshwari Y "Acute esophageal necrosis: report of two cases and review of the literature," Gastrointest Endosc, vol. 49 (4 Pt 1), pp. 527-32, 1999 Apr.

Augusto F, Fernandes V, Cremers MI, Oliveira AP, Lobato C, Alves AL, Pinho C, de Freitas J "Acute necrotizing esophagitis: a large retrospective case series," Endoscopy, vol. 36(5), pp. 411-5, 2004 May.

Ben Soussan E, Savoye G, Hochain P, Hervé S, Antonietti M, Lemoine F, Ducrotté P "Acute esophageal necrosis: a 1 year prospective study," Gastrointest Endosc, vol. 56(2), pp. 213-7, 2002 Aug.

Ullah W, Mehmood A, Micaily I, Khan MS "Comprehensive review of acute esophageal necrosis," BMJ Case Rep, vol. 12(2), 2019 Feb 26.

Shafa S, Sharma N, Keshishian J, Dellon ES "The black esophagus: a rare but deadly disease," ACG Case Rep, vol. 3(2), pp. 88-91, 2016 Jan.

Grudell AB, Mueller PS, Viggiano TR "black esophagus: report of six cases and review of the literature, 1963-2003," Dis Esophagus, vol. 19(2), pp. 105-10, 2006.

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