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GMJ News > GMJ Briefs > Mortality in Acute Esophageal Necrosis Ranges 5-35% Based on Recognition Speed

Mortality in Acute Esophageal Necrosis Ranges 5-35% Based on Recognition Speed

GMJ
Last updated: 02/07/2026 18:26
By
Prof. Giorgi Pkhakadze
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Endoscopic view showing black esophageal mucosa characteristic of acute esophageal necrosis
A rare case of acute esophageal necrosis documented in NEJM highlights the critical need for early recognition of this life-threatening "black esophagus" condition. The distinctive circumferential black discoloration on endoscopy defines this gastrointestinal emergency. — Bi-lingual Clinical Trial Consultation (45067326622).jpg by NIAID / CC BY 2.0 via Wikimedia Commons (CC BY 2.0)
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1 min read|116 words

Systematic literature review data reveals a striking correlation between prompt clinical recognition and patient survival in acute esophageal necrosis, with mortality rates ranging from 5% to 35% depending on intervention timing. When recognized and managed early, the prognosis improves dramatically, with mortality dropping to approximately 5%.

The distinctive endoscopic hallmark—circumferential black discoloration of the esophageal mucosa—serves as a critical diagnostic clue. Clinical data demonstrates that 85% of patients present with upper gastrointestinal bleeding, while 72% experience severe chest pain. Shock develops in 45% of cases, and only 35% achieve complete recovery. These statistics underscore why rapid endoscopic identification is essential in emergency settings and why familiarity with this rare condition’s presentation can be lifesaving.

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ByProf. Giorgi Pkhakadze
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Prof. Giorgi Pkhakadze, MD, MPH, PhD, is Editor-in-Chief of the Georgian Medical Journal and Chair of the Public Health Institute of Georgia (PHIG). He is Professor and Head of the Department of Social and Behavioural Sciences at David Tvildiani Medical University, and Secretary/Treasurer of the UEMS Section of Public Health. ORCID: 0000-0001-7609-4515.

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