Steakhouse syndrome causing large esophageal ulcer and stenosis

Figure 1 Course of endoscopic findings. A: Findings on initial endoscopy (day 3). An ulcerated lesion covered by a thick white coating is seen in the upper esophagus. The esophageal lumen is narrowed, with easy friability. No distinct surrounding ridge is evident, but ulcer margins are irregular; B: Findings on second endoscopy (day 9). Deep ulceration with a whitish coating is seen at the 3 and 9 o’clock positions in the lumen. Compared to the initial endoscopic findings, esophageal stenosis has improved; C: Findings on third endoscopy (day 23). The white coating has disappeared, and the esophageal ulcer is healed and scarred.

Figure 2 Magnetic resonance imaging (MRI) findings. A: Chest T1-weighted MRI, transverse section. Circumferential wall thickening is seen in the cervical esophagus; B: Chest MRI with gadolinium contrast, sagittal section. Esophageal wall thickening extends about 4 cm, and a contrast effect is evident.