Acute necrotizing esophagitis in an unstable patient

Acute necrotizing esophagitis or black esophagus is a rare affection, described in the medical literature, since 1990. Although its mechanism is not fully understood, ischemic compromise appears to be the fundamental physiopathological factor. When acute necrotizing esophagitis is found in the endoscopic study of an upper digestive haemorrhage. the prognosis is good. We present a case in which diagnosis of black esophagus was an endoscopic finding, secondary to a situation of underlying hemodynamic instability, with a fatal outcome.