BLACK ESOPHAGUS: A CASE SERIES

Black esophagus is a rare endoscopic finding. While the etiology remains unknown, it occurs in elderly patients and/or those with comorbid conditions, particularly vascular disorders. It usually involves the distal third of the esophagus. The most common presenting symptom is acute esophageal bleeding. The natural history of the disease is that of spontaneous resolution. The differential diagnosis includes acute necrotizing esophagitis, melanosis, pseudo‐melanosis, melanoma, acanthosis nigricans, and caustic substance (lye) ingestion. Some associated conditions include ischemia, prolonged hypotension, hyperglycemia, hypersensitivity to antibiotics, herpetic infection, aortic dissection, and anti‐cardiolipin antibodies. The pathogenesis of black esophagus is not fully understood, but it is hypothesized that low systemic perfusion plays a dominant role. The present report describes three women diagnosed during esophagogastroduodenoscopy with black esophagus. Two of our patients presented with hypertensive emergencies, an association not reported in the literature. One of the patients described developed Gram‐negative bacteremia after esophagogastroduodenoscopy, an unreported sequelae of black esophagus.