ArticleFrontiers in medicine2026
Case report: Three contrasting presentations of acute oesophageal necrosis and the determinants of outcome.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Acute oesophageal necrosis (AEN), or "black oesophagus," is a rare but potentially lethal cause of upper gastrointestinal bleeding (UGIB), classically described in elderly men with cardiovascular comorbidity. Contemporary reports emphasize a broader clinical spectrum encompassing younger immunosuppressed and critically ill patients. Case description: We describe three patients managed at a single tertiary Malaysian center. Case 1: a 77-year-old man with type 2 diabetes and stage 3b chronic kidney disease, not on anticoagulation, presented with coffee-ground vomitus; endoscopy revealed circumferential blackish necrosis of the distal two-thirds of the oesophagus; he was treated with submucosal adrenaline injection and supportive care and achieved complete mucosal healing at 6 weeks. Case 2: a 52-year-old woman with relapsed focal segmental glomerulosclerosis on prednisolone and ciclosporin, complicated by methicillin-sensitive Conclusion: These three contrasting cases illustrate the heterogeneity of AEN and reinforce the contemporary teaching that long-term outcome is determined principally by the underlying systemic illness. AEN should be considered in any acutely unwell patient with UGIB regardless of demographic profile, including immunosuppressed and long-term dialysis recipients.
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