The differential diagnosis of black esophagus includes ischemic necrosis of the esophagus, exogenous and endogenous pigmentation, and hypersensitivity-related mucosal reactions.
Underlying conditions that are believed to predispose patients to an ischemic black esophagus include coronary and peripheral vascular diseases, low flow states (e.
Black esophagus associated with herpes esophagitis.
Black esophagus is known to the gastroenterology community and carries a mortality rate as high as 38% in the literature; however, to our knowledge it is virtually unknown in the pathology literature with only a single instance described in 1967.
Black esophagus, or acute necrotizing esophagitis, is a rare entity with a reported incidence of 0.