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Upper gastrointestinal endoscopy: (A) circumferential black pigmentation, fragile necrotic mucosa, and multiple superficial ulcerations in the middle and lower thirds of esophagus and (B) the lower one-third of the esophagus was covered with dark coffee-ground exudates, oozing fresh red-colored blood with minimal touch.
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Esophagogastroduodenoscopy was done and showed circumferential black pigmentation, fragile esophageal necrotic mucosa, and multiple superficial ulcerations in the middle and lower thirds of esophagus (Figure 1A). The lower one-third of esophagus was covered with dark exudates, oozing fresh red-colored blood with minimal touch (Figure 1B).
Microscopic examination of lower esophageal biopsy: (A) small fragments of gastroesophageal mucosa with focal area of ulceration (hematoxylin and eosin stain; magnification power: 10x) and (B) the ulcerated area was replaced by local inflammatory changes comprising necrotic debris, neutrophil exudates, hemorrhage, and background fibrinous material deposition (hematoxylin and eosin stain; magnification power: 40x).
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Histopathological examination was negative for malignancy and revealed small fragments of gastroesophageal mucosa with a focal area of ulceration (Figure 2A). The ulcerated area was replaced by local inflammatory changes comprising necrotic debris, neutrophil exudates, hemorrhage, and background fibrinous material deposition (Figure 2B).