An Unusual Distal Esophageal Finding: An Endoscopic Challenge

Abstract

A 66-year-old woman with a history of type 2 diabetes mellitus, hypertension, and advanced chronic kidney disease on peritoneal dialysis was admitted with peritoneal dialysis-associated peritonitis. During hospitalization, she developed intolerance to oral intake, progressive dysphagia, epigastric pain, and coffee-ground emesis. Laboratory evaluation revealed moderate normocytic normochromic anemia, leukocytosis with neutrophilia, hypoalbuminemia (2.1 g/dL), and hyperglycemia (up to 303 mg/dL). Peritoneal fluid analysis showed 1,130 leukocytes/mm³ with 78% polymorphonuclear cells and Gram-negative bacilli on Gram staining, supporting the diagnosis of peritoneal dialysis-associated peritonitis.