[Acute esophageal necrosis from the emergency physician's perspective]

Acute esophageal necrosis, also known as "black esophagus" or Gurvits syndrome, is a rare but severe cause of upper gastrointestinal bleeding. It mainly affects elderly, frail and polymorbid patients, often in the setting of systemic low-flow states or severe metabolic disorders. The clinical presentation is dominated by hematemesis or melena. Diagnosis relies on endoscopy, which reveals circumferential black discoloration of the distal third of the esophagus, stopping at the gastroesophageal junction. Management is primarily symptomatic and etiological, combining hemodynamic stabilization, acid-suppressive therapy and treatment of the underlying cause. Complications, notably perforation, may require surgical intervention.