TY - BOOK AU - Chaudhary, Fizah S AU - Farooqi, Rehan AU - Naqvi, Haider A AU - Saleh, Nahar AU - Siddiqi, Anees AU - Yousaf, Muhammad Nadeem TI - Black esophagus: a syndrome of acute esophageal necrosis associated with active alcohol drinking SN - 2054-4774 PY - 2020/// KW - IN PROCESS -- NOT YET INDEXED KW - MedStar Health Baltimore Residents KW - MedStar Union Memorial Hospital KW - Medicine KW - Journal Article N2 - Black esophagus, also known as acute esophageal necrosis (AEN) syndrome, is a rare entity characterized by patchy or diffuse circumferential black pigmentation of the esophageal mucosa from ischemic necrosis. It may present with life-threatening upper gastrointestinal hemorrhage resulting in high mortality in immunocompromised patients. Advanced age with multiple comorbidities compounded with compromised hemodynamic states are poor prognostic factors. Findings on laboratory work-up and radiological imaging are non-specific. After initial resuscitation, endoscopic evaluation and histological examination of esophageal biopsy are diagnostic. Early recognition and aggressive resuscitation are the fundamental principles for the management of AEN and better outcome of the disease. We report a case of a 56-year-old woman with diabetes mellitus, gastro-esophageal reflux disease, and active alcohol binging who presented with hematemesis and acute epigastric pain due to AEN. This case illustrates a rare etiology of AEN due to active alcohol drinking, which may be overlooked. Physician awareness about this etiology is important as early recognition and timely management may improve survival. Copyright (c) Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ UR - https://dx.doi.org/10.1136/bmjgast-2020-000466 ER -