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Clinical and Endoscopic Characteristics

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Dysphagia, odynophagia, chest pain, heartburn, vomiting or cough are reported in 45% of patients, include. The mid‐distal esophagus is most commonly involved. Endoscopy reveals white plaques or membranes, and there may be sloughing of the epithelium as well as other nonspecific findings such as erythema, erosions, rings, or webs. In black esophagus, the sloughing necrotic membrane may appear blackened (Figure 2.17). The clinical presentation is distinctive with bleeding and a characteristic diffuse circumferential black mucosal discoloration of the distal esophagus with an abrupt transition at the gastroesophageal junction.

Figure 2.17 Endoscopic appearance of necrotizing esophagitis with appearance of “black esophagus.”


Figure 2.18 Characteristic appearance of sloughing esophagitis with two‐tone appearance of the esophageal mucosa.

Gastrointestinal Pathology

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