Black esophagus and duodenal perforation : more than an incidental association

Black esophagus has an estimated incidence ranging from 0.01% to 0.28% in large endoscopy series (1). It is characterized by a circumferential black colored necrotic esophageal mucosa with a predilection to the distal esophagus and turning sharply to normal at the gastro- esophageal junction. The etiology includes a combined effect of ischemic injury, impaired esophageal mucosal defense systems, and backflow injury from gastric con- tents. Herein we report a patient with black esophagus and perforated duodenal ulcer suggesting that the com- mon blood supply of the two entities makes them etio- logically related.