Acute esophageal necrosis (“black esophagus”): Case series in forensic autopsies casuistry

A. A. Keresztesi, G. Asofie, L. Chinezu, H. Jung,

Abstract: Acute esophageal necrosis or “black esophagus” is a rare medical condition characterized by necrosis of the esophageal mucosa, most of the time limited to the distal esophagus. We present three such autopsied cases, all men with a history of chronic alcohol abuse, all from the same area in Mures County and in the same period of time (a few months apart). Histological examination confirmed necrosis in all cases, and a violent nature of the necrosis (acute intoxication with caustic substances) was excluded based on the strict limitation of the necrosis to the medium and inferior esophagus. Also, H-PAS stain was performed, to investigate possible fungal infections, often cause of esophageal necrosis in immunosuppressed patients. We found alcoholism and diabetes mellitus as risk factors for esophageal necrosis and believe that in establishing cause of death the forensic pathologist must consider other internal organs involvement more than the role of the injured esophagus.
Keywords: acute esophageal necrosis, black esophagus, forensic autopsy.