Fig. 4

Gross and histopathological appearances of the resected specimen. A Macroscopic view of the resected specimen, showing perforation of the lower esophagus (white ellipses). The esophageal mucosa has totally turned black, and the gastric mucosa is intact. B Histopathologically, extensive necrosis is observed from the mucosal layer to the submucosal layer, extending partially to the muscularis propria. Neutrophilic infiltration is prominent in the lamina propria and extends to the adventitia