Abstract: Stress ulcer bleeding commonly occurs in patients with extensive burns. In this article, one patient who vomited a dark red long cord-like substance after more than 20 days of burns was reported. Emergency gastroscopy showed obvious congestion of the mucosa from the entire esophagus to the gastric pylorus. A large amount of bright red bloody fluid was seen in the middle and lower parts of the esophagus, and extensive mucosa fell off. The diagnosis of stress ulcer bleeding and esophageal tube type was considered. The long cord-like substance was pathologically confirmed to be mixed thrombus after examination, and no clear gastroesophageal mucosa was found. The clinical manifestations of this case were extremely rare, resulting in our misdiagnosis as an esophageal tube type. In this article, the causes of misdiagnosis and special clinical manifestations were analyzed, aiming to raise awareness of the special symptoms and signs of stress ulcer bleeding after burns, reduce the risk of misdiagnosis, and improve the ability of early detection, diagnosis and treatment of this disease by sharing this case with our peers.