A ‘shock-ing’ endoscopic finding on esophagogastroduodenoscopy

Black esophagus is a rare clinical entity, first described in 1990 by Goldenberg et al ,1 the pathogenesis of which is not fully understood,2 but is believed to arise as a result of ischaemic insult seen in haemodynamic compromise and low-flow states, corrosive injury from gastric contents in the setting of esophagogastroparesis and gastric outlet obstruction, and decreased function of mucosal barrier systems and reparative mechanisms present in malnourished and debilitated physical states. We present a case of 55-year-old woman with stage-IV metastatic lung adenocarcinoma on tarceva (erlotinib) who was admitted with coffee-ground emesis, sepsis and multiorgan failure. She was on …