Black Esophagus Under the Scope: Gurvits Syndrome in a Patient With Diabetic Ketoacidosis

A 60-year-old woman with a history of uncontrolled type 2 diabetes mellitus (DM), hypertension, and coronary artery disease was admitted to the intensive care unit due to diabetic ketoacidosis (DKA) triggered by urosepsis. During her stay, she developed upper gastrointestinal bleeding, manifesting as melena. Esophagogastroduodenoscopy revealed circumferential necrosis of the mid-to-distal esophagus, consistent with acute esophageal necrosis (AEN). The patient received supportive treatment, including proton pump inhibitor therapy and sucralfate. A follow-up gastroscopy four weeks later showed a resolution of necrosis but persistent mild esophagitis. This case highlights AEN as a rare complication in patients with uncontrolled type 2 DM and DKA.