The black esophagus and duodenum: a rare case report

Area of Science:

• Gastroenterology
• Internal Medicine
• Pathology

Background:

• Acute esophageal necrosis is a rare condition characterized by circumferential black mucosa, typically in the distal esophagus.
• It predominantly affects elderly males with multiple comorbidities.
• Co-occurrence with ischemic duodenum is exceptionally rare.

Observation:

• A 71-year-old male presented with upper gastrointestinal bleeding.
• The patient subsequently developed acute necrotizing esophagus and duodenum.
• This presentation is highly unusual, with only one prior reported case of concurrent esophageal and duodenal ischemia.

Findings:

• The case demonstrates a severe manifestation of upper gastrointestinal compromise.
• Esophageal and duodenal necrosis can occur concurrently, presenting a diagnostic and therapeutic challenge.
• The black, circumferential appearance is a hallmark of esophageal necrosis.

Implications:

• This case expands the understanding of acute esophageal necrosis and its potential co-occurrence with ischemic duodenal injury.
• Highlights the importance of considering widespread gastrointestinal ischemia in patients with severe upper GI bleeding and risk factors.
• Further research may elucidate shared pathophysiological mechanisms and optimal management strategies for this rare condition.