"Black esophagus": a rare complication of shock.

An 83-yr-old man was admitted to our hospital in a state of shock. Twenty four hours after his admission, he started to pass fresh blood from his nasogastric tube. Upper endoscopy revealed diffuse, confluent blackening of the esophageal mucosa. A repeated endoscopy, after hemodynamic stabilization, demonstrated a striking improvement with granulation tissue. Caustic injury and viral or fungal infections were ruled out by history, clinical features, and appropriate tests. We suggest that in this elderly patient, a state of shock resulted in ischemic infarction of the esophageal mucosa.