A black perforated esophagus treated with surgery: Report of a case

Abstract

A case of a perforated black esophagus treated with minimal invasive surgery is presented. A 68-year-old women underwent a right-sided hemihepatectomy and radio frequency ablation of two metastasis in the left liver lobe. Previous history revealed a hemicolectomy for an obstructive colon carcinoma with post-operative chemotherapy. Postoperatively she developed severe dyspnea due to a perforation of the esophagus with leakage to the pleural space. Video-assisted thoracoscopic surgery (VATS) to adequately drain the perforation was performed. Gastroscopy revealed a perforated black esophagus. The black esophagus, acute esophageal necrosis or Gurvits syndrome is a rare entity with an unknown aetiology which is likely to be multifactorial. The estimated mortality rate is high. To our knowledge, this is the first case published of early VATS used in a case of perforated black esophagus.

Keywords: Acute esophageal necrosis; Black esophagus; Gastrointestinal surgery; Perforated esophagus; Video assisted thoracoscopic surgery.

Figure 1

Computed tomography-thorax scan with contrast given via the nasogastric feeding tube. A: A coronal coupe where the esophagus is seen to the left of the vertebral column and the perforation lights up two thirds of the esophagus with leakage of contrast into the pleural space; B and C: Transversal coupes of the thorax with contrast leakage via the esophagus into the pleural space; D and E: A circumferentially black-appearing esophagus at endoscopy.