# 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.

## Key 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.