Abstract
Acute esophageal mucosal lesion (AEML) is a comprehensive disease that includes necrotizing and acute erosive esophagitis, and occasionally results in upper gastrointestinal bleeding. We classified 88 patients with AEML into two categories, i.e., 18 patients with black esophagitis and 70 patients with non-black esophagitis, and subsequently examined their clinicopathological features. Elderly men, sliding hernia and gastroduodenal ulcers were frequent in both groups, with no significant differences noted between the subtypes. Mortality was 28% and 13%, respectively, showing no significant difference, and was associated with exacerbation of the underlying diseases. The area of inflammation was more broadly extended and delay of mucosal healing was observed more frequently in the black esophagitis group relative to the non-black esophagitis group. In addition, delayed esophageal stenosis was more frequently observed in the former group. Furthermore, the black esophagitis group required longer periods of intravenous feeding (8.7 days vs. 3.8 days ; p=0.004) and hospitalization (33.1 days vs. 12.8 days ; p<0.001) compared to the non-black esophagitis group. In summary, black and non-black esophagitis are considered to belong to the same disease entity. However, black esophagitis may represent a more severe clinical subtype.
