Acute oesophageal necrosis following ethyl-induced emesis: A Case Report

Acute oesophageal necrosis, also known as black oesophagus or Gurvits syndrome, is a rare condition characterized by black discoloration of the distal oesophageal mucosa due to mucosal necrosis, typically with an abrupt transition at the gastroesophageal junction. We report a case of Gurvits syndrome in a 73-year-old man with poorly controlled type 2 diabetes mellitus and recent alcohol-induced vomiting, without ingestion of caustic substances. The patient experienced epigastric pain while remaining hemodynamically stable without significant biochemical abnormalities. Following supportive therapy with bowel rest, intravenous fluids, acid suppression, glycemic control and empiric antibiotics followed by enteral feeding via jejunostomy, patient recovered completely without complications. We observed progressive mucosal healing on follow-up endoscopy. This case highlights the importance of early recognition and supportive management of acute oesophageal necrosis, especially in patients with predisposing factors such as diabetes mellitus, vomiting, to achieve full recovery and avoid adverse outcomes.

Keywords: black oesophagus, oesophageal necrosis, endoscopy, alcohol-induced vomiting.