Acute esophageal necrosis: A rare case of upper gastrointestinal bleeding from diabetic ketoacidosis

Abstract

Acute esophageal necrosis, also known as black esophagus or acute necrotizing esophagitis is a rare condition with roughly 154 cases reported in the literature. This condition is classically diagnosed on its endo-scopic findings of a circumferentially black esophagus that abruptly ends at the gastroe-sophageal junction and transitions to normal gastric mucosa. When present, acute esophageal necrosis potentially signifies a poor prognosis with an overall mortality up to 36%. This case report describes a critically ill patient with multiple comorbidities that was found to have acute esophageal necrosis the entire length of the esophagus secondary to ischemia/hypoperfusion that was caused by diabetic ketoacidosis. The patient had a pro-longed hospitalization but was ultimately dis-charged in stable condition. We also review the literature of this rare esophageal condition.