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Acute esophageal necrosis complicated by esophageal perforation due to orogastric tube placement. On upper endoscopy, black necrotic mucosa was found throughout the esophagus, and there was a disruption of the distal esophagus where the right pleural space could be entered with visualization of the right lung and parietal pleura. The free esophageal perforation was too large for endoscopic intervention.
