PMC5494557_01
Middle esophagus showing discoloration, erythema, friability (with contact bleeding), granularity, hemorrhagic appearance, inflammation, nodularity, altered texture, and a decreased vascular pattern.
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fig1
An emergent upper GI endoscopy was performed which revealed diffuse severe mucosal changes characterized by black interspersed with erythematous mucosa which was friable and granular and had decreased vascular pattern in the middle third and lower third of the esophagus concerning for ischemia (Figure 1).
Moderate size hiatal hernia, esophageal enlargement diffusely with hyperdense material noted centrally within the stomach and distal esophagus. Given the history, this is concerning for gastric/distal esophageal hemorrhage but remains nonspecific. Acute sternal fracture was also found.
CRIGM2017-5092906.002.jpg
PMC5494557_01_CRIGM2017-5092906.002.jpg
fig2
CT thorax (Figure 2) revealed diffusely enlarged esophagus with hyperdense material noted in the distal esophagus, fundus of the stomach, concerning for hemorrhage into the stomach.