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Gut 2005;54:192; doi:10.1136/gut.2004.044784
Copyright © 2005 BMJ Publishing Group Ltd & British Society of Gastroenterology.
Gut 2005;54:192
© 2005 by BMJ Publishing Group Ltd & British Society of Gastroenterology

EDITOR'S QUIZ: GI SNAPSHOT

Black oesophagus—cause?

A Sako1, J Kitayama1, T Inoue1, S Kaizaki1, H Nagawa1, H Suzuki2

1 Department of Surgical Oncology, University of Tokyo, Tokyo, Japan
2 Suzuki Hospital, Tokyo, Japan

Correspondence to:
Correspondence to:
Dr A Sako
Department of Surgical Oncology, University of Tokyo, Hongo7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan; sakou-dis@h.u-tokyo.ac.jp

Keywords: acute oesophageal necrosis; black oesophagus

The first 150 words of the full text of this article appear below.

Clinical presentation

A 64 year old woman was admitted with coffee ground emesis. She had been bedridden for the previous two years due to osteoarthritis but had no past history of upper gastrointestinal ulcer, gastro-oesophageal reflux disease, or corrosive intake. Initial upper endoscopy revealed a patchy black appearance of the oesophageal mucosa extending from the proximal third of the oesophagus, with adherent yellow exudates, which became circumferential in the distal third of the oesophagus (fig 1Go). The black mucosa showed a sharp boundary at the gastro-oesophageal mucosal junction (fig 1Go), and the gastric and duodenal mucosa showed a normal appearance. The patient was treated with intravenous ranitidine for seven days and oral ranitidine thereafter. Endoscopy one week later revealed that the oesophageal mucosa was diffusely covered by thin whitish exudates with no stenosis, and biopsies revealed ulcerated mucosa with massive necrosis.


 


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EDITOR’S QUIZ: GI SNAPSHOT
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