Black and White Esophagus: Rare Presentations of Severe Esophageal Ischemia

Daniel B. Kim, Steven Bowers, Mathew Thomas

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Benign esophageal strictures are typically the result of long-standing gastroesophageal reflux, and are usually treated with serial dilations and acid-suppressive therapy. Other causes of benign esophageal strictures include external beam radiation, caustic ingestions, prior surgery, and external compression from mediastinal fibrosis. We report 2 rare causes of ischemic esophageal structuring occurring after operations unrelated to the esophagus. The first is a patient who developed esophageal injury following radiofrequency ablation for atrial fibrillation. The direct thermal injury resulted in a “white esophagus” with a full-thickness, long-segmental stricture. The second patient presented with a “black esophagus” also known as acute necrotizing esophagitis. This occurred after an orthotopic liver transplant, which was complicated by multiple organ dysfunction secondary to hemorrhagic shock. In this report, we present 2 rare causes of esophageal stricturing that occurred after procedures not necessarily related to the esophagus itself. Early recognition and active management of these esophageal injuries may lead to better outcomes.

Original languageEnglish (US)
Pages (from-to)256-259
Number of pages4
JournalSeminars in thoracic and cardiovascular surgery
Issue number2
StatePublished - Feb 2 2017


  • acute necrotizing esophagitis
  • black esophagus
  • esophageal ischemia
  • esophageal stricture
  • white esophagus

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine


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