A Case of Diabetic Ketoacidosis Complicated With Necrotizing Esophagitis

TL;DR

A patient with type 1 diabetes developed diabetic ketoacidosis complicated by necrotizing esophagitis, which improved with proton pump inhibitor treatment.

Contribution

This case report highlights the rare but serious complication of necrotizing esophagitis in a patient with type 1 diabetes and diabetic ketoacidosis.

Findings

A 49-year-old man with type 1 diabetes presented with vomiting and was diagnosed with diabetic ketoacidosis.

Upper gastrointestinal endoscopy revealed black mucosa consistent with acute necrotizing esophagitis.

Treatment with proton pump inhibitors led to marked improvement and the patient was discharged after 20 days.

Abstract

Acute necrotizing esophagitis (ANE) is known as the "black esophagus." We present a case of ANE in a patient with slowly progressive type 1 diabetes mellitus. A 49-year-old man presented with vomiting, characterized by coffee residue-like emesis, and was diagnosed with diabetic ketoacidosis. Upper gastrointestinal endoscopy revealed black mucosa extending from the middle of the esophagus to the gastric junction, leading to a diagnosis of ANE. The patient was treated with proton pump inhibitors and showed marked improvement. The patient was discharged on the 20th day of illness.

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