Clin Endosc.  2020 May;53(3):366-369. 10.5946/ce.2019.066.

Corrosive Esophageal Injury due to a Commercial Vinegar Beverage in an Adolescent

• Chang J
• Han SE
• Paik SS
• Kim YJ

• KMID: 2502773
• DOI: http://doi.org/10.5946/ce.2019.066

Abstract

Although gastroesophageal damage is commonly induced by accidental drinking of a strong acid or alkali, damage due to the consumption of a vinegar beverage is not well known. We report a case of corrosive esophageal ulcer found in an adolescent consuming a vinegar drink daily. A 15-year-old male visited the emergency room presenting with hematemesis and severe epigastric pain. Multiple longitudinal ulcers, concurrent mucosal hemorrhage, and denuded mucosa were noted in the whole of the esophagus via an endoscopic examination. He had been drinking a vinegar beverage daily without sufficient dilution. The patient was treated with corticosteroid, antibiotic therapy, and mucosa protecting alginate medication and was asked to fast for a week. The follow-up endoscopy showed improvement of the esophageal injuries. Overall, continuous consumption of a vinegar beverage can result in acidic burns and destruction of the surface of the upper gastrointestinal tract. Therefore, vinegar beverages should be considered as corrosive agents.

Keyword

Caustic; Corrosive esophagitis; Acid beverage; Adolescent

Figure

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  Fig. 1. Contrast enhanced abdominal computed tomography image of the patient. The image showed swelling in the distal esophagus (A, arrowheads) and gastric cardia (B, arrowheads). The swelling of the esophagus was later documented to be severely ulcerated with a hemorrhagic mucosal injury (A inlet) and that of gastric cardia to be verrucous gastritis with chronic inflammation (B inlet, arrows).

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  Fig. 2. Esophagoscopic findings of the patient. The initial esophagoscopy showed multiple longitudinal ulcers with concurrent mucosal hemorrhage and denuded mucosa in the whole esophagus (A). The follow-up esophagoscopy showed that the previous esophageal injuries were completely resolved (B).

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  Fig. 3. Pathologic findings of the esophageal lesion. The esophageal biopsy showed minimal parakeratosis, some red blood cells (RBCs), and many eosinophilic infiltrates (A). Another section of the esophageal biopsy showed minimal parakeratosis, some RBCs, and many eosinophilic infiltrates (B). A neutrophil was also noted (arrow) (hematoxylin and eosin, ×400).

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