A 52-year-old man arrived at the hospital after two days of vomiting coffee-brown material and passing black, tarry stools. A few hours before his symptoms began, he had been binge drinking. Blood tests showed a glucose level of 454 mg/dL, ketones in his urine, and a blood pH of 7.2, signs of diabetic ketoacidosis.
When doctors passed a camera down his throat, they found that the lining of his entire esophagus had turned black. The dead tissue wrapped all the way around the tube and stopped abruptly where the esophagus meets the stomach. His stomach and the first part of his small intestine were spared.
