| Age; sex |
45 yr; female |
66 yr; female |
| Clinical presentation |
Septic shock, acute upper gastrointestinal bleeding |
Diabetic ketoacidosis, coffee ground emesis, and epigastric pain |
| Associated condition |
Malnutrition, GERD, chronic liver disease, and alcoholism |
Malnutrition, coronary artery disease, hypertension, and diastolic heart failure |
| Hemoglobin (g/dL) |
9.5 |
8.5 |
| Creatinine (mg/dL) |
7.1 |
1.9 |
| Lactic acid (<2.1 mmol/L) |
10 |
1 |
| Procalcitonin (>0.5 ng/mL is positive) |
19.7 |
1.8 |
| Endoscopic features |
Circumferential black esophagus from mid to distal third w/intramural esophageal dissection Duodenal ulcerations with low risk stigmata for bleeding |
Isolated circumferential black esophagus from mid to distal third |
| Etiology |
Malnutrition, alcoholism, chronic acid reflux, sepsis, and ischemia |
DKA, systemic hypotension, ischemia, and possibly low flow ischemia |
| Clinical outcome |
Deceased |
Alive at discharge without short-term complications |
