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Acute esophageal necrosis (black esophagus)

INTRODUCTION

Acute esophageal necrosis (AEN) has been referred to by multiple names including black esophagus, and necrotizing esophagitis [1-3]. It is best described by the following criteria [4]:

Acute presentation with endoscopic findings consisting of a circumferential black esophagus with or without exudates.

Distal esophageal involvement that can extend proximally, but ends sharply at the gastroesophageal border.

Uniform histologic findings affecting the mucosa and submucosa and consisting of diffuse and severe necrosis, without recognizable stratified squamous cells, occasional deranged muscle fibers, hyperemia and scattered thrombosed vessels without specific causative agents.

Occurrence in the absence of caustic or other injurious agents.

              

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Literature review current through: Aug 2014. | This topic last updated: Jan 20, 2014.
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References
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  1. Brennan JL. Case of extensive necrosis of the oesophageal mucosa following hypothermia. J Clin Pathol 1967; 20:581.
  2. Obermeyer R, Kasirajan K, Erzurum V, Chung D. Necrotizing esophagitis presenting as a black esophagus. Surg Endosc 1998; 12:1430.
  3. Geller A, Aguilar H, Burgart L, Gostout CJ. The black esophagus. Am J Gastroenterol 1995; 90:2210.
  4. Moretó M, Ojembarrena E, Zaballa M, et al. Idiopathic acute esophageal necrosis: not necessarily a terminal event. Endoscopy 1993; 25:534.
  5. Etienne JP, Roge J, Delavierre P, Veyssier P. [Esophageal necrosis of vascular origin]. Sem Hop 1969; 45:1599.
  6. Postlethwait RW, Musser AW. Changes in the esophagus in 1,000 autopsy specimens. J Thorac Cardiovasc Surg 1974; 68:953.
  7. Lacy BE, Toor A, Bensen SP, et al. Acute esophageal necrosis: report of two cases and a review of the literature. Gastrointest Endosc 1999; 49:527.
  8. Augusto F, Fernandes V, Cremers MI, et al. Acute necrotizing esophagitis: a large retrospective case series. Endoscopy 2004; 36:411.
  9. Julián Gómez L, Barrio J, Atienza R, et al. [Acute esophageal necrosis. An underdiagnosed disease]. Rev Esp Enferm Dig 2008; 100:701.
  10. Ben Soussan E, Savoye G, Hochain P, et al. Acute esophageal necrosis: a 1-year prospective study. Gastrointest Endosc 2002; 56:213.
  11. Goldenberg SP, Wain SL, Marignani P. Acute necrotizing esophagitis. Gastroenterology 1990; 98:493.
  12. Jacobsen NO, Christiansen J, Kruse A. Incidence of oesophageal necrosis in an autopsy material. APMIS 2003; 111:591.
  13. Haviv YS, Reinus C, Zimmerman J. "Black esophagus": a rare complication of shock. Am J Gastroenterol 1996; 91:2432.
  14. Reichart M, Busch OR, Bruno MJ, Van Lanschot JJ. Black esophagus: a view in the dark. Dis Esophagus 2000; 13:311.
  15. Mangan TF, Colley AT, Wytock DH. Antibiotic-associated acute necrotizing esophagitis. Gastroenterology 1990; 99:900.
  16. Cattan P, Cuillerier E, Cellier C, et al. Black esophagus associated with herpes esophagitis. Gastrointest Endosc 1999; 49:105.
  17. Kram M, Gorenstein L, Eisen D, Cohen D. Acute esophageal necrosis associated with gastric volvulus. Gastrointest Endosc 2000; 51:610.
  18. Matsumoto N, Oki E, Morita M, et al. Successful treatment of acute esophageal necrosis caused by intrathoracic gastric volvulus: report of a case. Surg Today 2009; 39:1068.
  19. Mahé A, Kéita S, Blanc L, Bobin P. Esophageal necrosis in the Stevens-Johnson syndrome. J Am Acad Dermatol 1993; 29:103.
  20. Katsinelos P, Pilpilidis I, Dimiropoulos S, et al. Black esophagus induced by severe vomiting in a healthy young man. Surg Endosc 2003; 17:521.
  21. Endo T, Sakamoto J, Sato K, et al. Acute esophageal necrosis caused by alcohol abuse. World J Gastroenterol 2005; 11:5568.
  22. Kim YH, Choi SY. Black esophagus with concomitant candidiasis developed after diabetic ketoacidosis. World J Gastroenterol 2007; 13:5662.
  23. Yamauchi J, Mitsufuji S, Taniguchi J, et al. Acute esophageal necrosis followed by upper endoscopy and esophageal manometry/pH test. Dig Dis Sci 2005; 50:1718.
  24. Hwang J, Weigel TL. Acute esophageal necrosis: "black esophagus". JSLS 2007; 11:165.
  25. Săftoiu A, Cazacu S, Kruse A, et al. Acute esophageal necrosis associated with alcoholic hepatitis: is it black or is it white? Endoscopy 2005; 37:268.
  26. van de Wal-Visscher E, Nieuwenhuijzen GA, van Sambeek MR, et al. Type B aortic dissection resulting in acute esophageal necrosis. Ann Vasc Surg 2011; 25:837.e1.
  27. Gurvits GE, Shapsis A, Lau N, et al. Acute esophageal necrosis: a rare syndrome. J Gastroenterol 2007; 42:29.
  28. Gurvits GE, Robilotti JG. Isolated proximal black esophagus: etiology and the role of tissue biopsy. Gastrointest Endosc 2010; 71:658.
  29. Neumann DA 2nd, Francis DL, Baron TH. Proximal black esophagus: a case report and review of the literature. Gastrointest Endosc 2009; 70:180.
  30. Sharma SS, Venkateswaran S, Chacko A, Mathan M. Melanosis of the esophagus. An endoscopic, histochemical, and ultrastructural study. Gastroenterology 1991; 100:13.
  31. Ohashi K, Kato Y, Kanno J, Kasuga T. Melanocytes and melanosis of the oesophagus in Japanese subjects--analysis of factors effecting their increase. Virchows Arch A Pathol Anat Histopathol 1990; 417:137.
  32. Berry MA, DiPalma JA. Esophageal melanosis. J Clin Gastroenterol 1995; 21:79.
  33. Kimball MW. Pseudomelanosis of the esophagus. Gastrointest Endosc 1978; 24:121.
  34. Guzman RP, Wightman R, Ravinsky E, Unruh HW. Primary malignant melanoma of the esophagus with diffuse melanocytic atypia and melanoma in situ. Am J Clin Pathol 1989; 92:802.
  35. DiCostanzo DP, Urmacher C. Primary malignant melanoma of the esophagus. Am J Surg Pathol 1987; 11:46.
  36. Hulshof MC, Van Haaren PM, Zum Vörde Sive Vörding PJ, et al. Radiotherapy combined with hyperthermia for primary malignant melanomas of the esophagus. Dis Esophagus 2010; 23:E42.
  37. Kozlowski LM, Nigra TP. Esophageal acanthosis nigricans in association with adenocarcinoma from an unknown primary site. J Am Acad Dermatol 1992; 26:348.
  38. Ramirez-Amador V, Esquivel-Pedraza L, Caballero-Mendoza E, et al. Oral manifestations as a hallmark of malignant acanthosis nigricans. J Oral Pathol Med 1999; 28:278.
  39. Khan HA. Coal dust deposition--rare cause of "black esophagus". Am J Gastroenterol 1996; 91:2256.
  40. Nayyar AK, Royston C, Slater DN, Bardhan KD. Pseudomembranous esophagitis. Gastrointest Endosc 2001; 54:730.
  41. Gurvits GE. Black esophagus: acute esophageal necrosis syndrome. World J Gastroenterol 2010; 16:3219.
  42. Gelrud D, Noyer C, Brenner S, Brandt LJ. Clinical outcomes of acute necrotizing esophagitis (abstract). Am J Gastroententerol 2000; 95:34.