The patient was a 63-year-old man. He vomited black-colored hematemesis the day after his heavy alcohol consumption. Due to falling into shock afterward, he was refered to Dokkyo Medical University Hospital. After administration of intravenous fluid to manage dehydration, his condition was improved. Since upper gastrointestinal bleeding was suspected, endoscopy was performed, which revealed extensive black necrosis in the mucosa of the lower esophagus. He was thus diagnosed as acute esophageal necrosis. He was kept in NPO and treated with intravenous administration of proton pump inhibitor. Examination by upper gastrointestinal endoscopy performed 12- and 22 days after the treatment demonstrated normal esophageal mucosa with regeneration. He began to intake foods without problems and discharged 23 days after admission. We herein report a rare case of acute necrotizing esophagitis presenting as a black esophagus on endoscopy.
