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Blue Esophagus

An 85-year-old female nursing home resident, with a known history of dementia, cerebrovascular disease, hypertension, and chronic dysuria, presented with a day's history of pain on the right side of the chest, nausea, and vomiting of blue material. When results from electrocardiography and cardiac enzyme testing were normal, computed tomography of the chest with intravenous contrast medium was performed to evaluate her symptoms. This examination revealed a markedly abnormal diffuse dilation of the distal esophagus with an air fluid level in the upper thoracic esophagus. Upper gastrointestinal endoscopy, surprisingly, revealed a vivid discoloration extending from the posterior pharynx to the ...

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