Acute esophageal necrosis (AEN) is rare and characterized endoscopically by distal esophageal ulceration, blackening, and necrosis. It typically arises in patients with multiple comorbidities who have significant systemic disease and frailty. Specific precipitating events are variable. Evidence suggests a multifactorial etiology likely involving esophageal ischemia in the setting of corrosive injury from gastric contents and impaired tissue repair mechanisms. In the transplant setting, immunosuppression likely plays a substantial role. We report a case of AEN in a 70-year-old man following a renal transplant.
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