A 22-year-old woman presented to the hospital with vomiting and epigastric pain. Few weeks back, she underwent laparoscopic cholecystectomy, which was complicated by mild pancreatitis. Following resolution she had gone on vacation and consumed moderate amounts of alcohol. On arrival she was hypotensive and tachycardic. Computed tomography revealed 50 necrosis of the pancreas. She required aggressive management in the intensive care unit. Nine days following admission she remained in severe epigastric pain with inability to tolerate nasojejunal nutrition. This was associated with throat pain and dysphagia. The decision was made to evaluate for the presence of an obstructing calculus in the common bile duct by endoscopy with ultrasonography. No calculus was identified, but endoscopy revealed linear lesions with sloughing of the superficial epithelium throughout the length of the esophagus (Figure 1).
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