{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:18:51Z","timestamp":1790036331829,"version":"4.0.1"},"reference-count":19,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,10,2]]},"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:p>Acute oesophageal necrosis, black oesophagus (BE) or Gurvits syndrome (GS) is a rare form of severe oesophagitis appearing as a striking circumferential discolouration of distal mucosa with various proximal extensions abruptly terminating at the gastro-oesophageal junction. It is most commonly associated with acute exacerbations of medical comorbidities, while associations with altered gut anatomy are rare. We present a unique constellation of BE, Cameron ulcers (CU), and gastric volvulus from a large paraesophageal hiatal hernia. Our patient recently recovered from COVID-19 and was malnourished and frail, while the expanding paraesophageal hiatal hernia turned into an acute organoaxial gastric volvulus with accompanying outlet obstruction. In low-flow post-COVID coagulopathic states, compensatory mechanisms may lack against gastric stunning and sudden massive reflux on the oesophagus. We additionally performed a systematic review and discovered additional cases with coexistent volvulus and paraesophageal hernia, although there are no previous reports of BE with CU, which makes this study the first.<\/jats:p>","DOI":"10.1136\/bcr-2021-246496","type":"journal-article","created":{"date-parts":[[2021,11,12]],"date-time":"2021-11-12T11:31:38Z","timestamp":1636716698000},"page":"e246496","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Black oesophagus, upside-down stomach and cameron lesions: cascade effects of a large hiatal hernia"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5239-9533","authenticated-orcid":false,"given":"Smit Sunil","family":"Deliwala","sequence":"first","affiliation":[{"name":"Internal Medicine, Hurley Medical Center, Flint, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4641-800X","authenticated-orcid":false,"given":"Murtaza S","family":"Hussain","sequence":"additional","affiliation":[{"name":"Internal Medicine, Hurley Medical Center, Flint, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anoosha","family":"Ponnapalli","sequence":"additional","affiliation":[{"name":"Internal Medicine, Hurley Medical Center, Flint, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6763-4508","authenticated-orcid":false,"given":"Ghassan","family":"Bachuwa","sequence":"additional","affiliation":[{"name":"Internal Medicine, Hurley Medical Center, Flint, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grigoriy E","family":"Gurvits","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology & Hepatology, New York University\/Langone Medical Center, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,11,12]]},"reference":[{"key":"2025082711315611000_14.11.e246496.1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-005-1741-6"},{"key":"2025082711315611000_14.11.e246496.2","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-006-1974-z"},{"key":"2025082711315611000_14.11.e246496.3","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v16.i26.3219"},{"key":"2025082711315611000_14.11.e246496.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(02)70180-6"},{"key":"2025082711315611000_14.11.e246496.5","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1016\/S0016-5107(00)70304-X","article-title":"Acute esophageal necrosis associated with gastric volvulus","volume":"51","author":"Kram","year":"2000","journal-title":"Gastrointest Endosc"},{"key":"2025082711315611000_14.11.e246496.6","doi-asserted-by":"crossref","first-page":"1068","DOI":"10.1007\/s00595-008-3983-4","article-title":"Successful treatment of acute esophageal necrosis caused by intrathoracic gastric volvulus: report of a case","volume":"39","author":"Matsumoto","year":"2009","journal-title":"Surg Today"},{"key":"2025082711315611000_14.11.e246496.7","doi-asserted-by":"crossref","DOI":"10.14309\/01.ajg.0000596828.44656.2b","article-title":"1824 Acute Esophageal Necrosis Secondary to Intrathoracic Gastric Volvulus Without Deadly Outcome","volume":"114","author":"Chowdhury","year":"2019","journal-title":"Am J Gastroenterol"},{"key":"2025082711315611000_14.11.e246496.8","first-page":"294","article-title":"Paraesophageal hernia and gastric volvulus: an uncommon etiology of vomiting and upper gastrointestinal bleeding","volume":"109","author":"Nunes","year":"2017","journal-title":"Rev Esp Enferm Dig"},{"key":"2025082711315611000_14.11.e246496.9","doi-asserted-by":"crossref","first-page":"2941","DOI":"10.1007\/s11695-018-3354-1","article-title":"\"Black Esophagus\" and Gastric Volvulus Following Slipped Laparoscopic Adjustable Gastric Band","volume":"28","author":"Moore","year":"2018","journal-title":"Obes Surg"},{"key":"2025082711315611000_14.11.e246496.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2010.12.001"},{"key":"2025082711315611000_14.11.e246496.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2013.07.025"},{"key":"2025082711315611000_14.11.e246496.12","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1007\/s00592-017-1028-4","article-title":"Acute esophageal necrosis (black esophagus): a case report and literature review","volume":"54","author":"Manno","year":"2017","journal-title":"Acta Diabetol"},{"key":"2025082711315611000_14.11.e246496.13","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1016\/j.clinre.2018.05.002","article-title":"Cameron lesions: a still overlooked diagnosis. 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