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Comprehensive review of acute oesophageal necrosis
  1. Waqas Ullah1,
  2. Asif Mehmood1,
  3. Ida Micaily1 and
  4. Muhammad Saeed Khan2
  1. 1 Department of Internal Medicine, Abington Hospital - Jefferson Health, Abington, Pennsylvania, USA
  2. 2 Department of Medicine, THQ Hospital Talash, Lower Dir, Khyber Pakhtunkhwa, Pakistan
  1. Correspondence to Dr Waqas Ullah, waqasullah.dr{at}


Acute oesophageal necrosis, also known as ‘black oesophagus’, is a rare condition characterised by the black discolouration of the oesophageal mucosa on endoscopy and involves the distal oesophagus in majority of cases but may also extend proximally. A number of conditions are found to be associated with it and it is thought to occur due to a combination of hypovolaemia and inadequate oesophageal protective mucosal barrier function. Gastric secretions may have a direct effect on the oesophageal mucosa. We present a case of a woman who presented with haematemesis and significant hypotension after a session of haemodialysis. Black oesophagus was confirmed on esophagogastroduodenoscopy. She was given two units of packed red blood cells and one unit of platelets, and started on a pantoprazole infusion. However, despite rigorous attempts at resuscitation the patient failed to recover.

  • GI bleeding
  • endoscopy
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  • Contributors WU did discussion, planning and conducted the literature search. IM was involved in case management and writing the presentation. AM helped in the conception and design of study. MSK helped in the acquisition of data and references.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Parental/guardian consent obtained.

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