[Partynight outcome].
METHODS
An 18 year old girl was admitted with progressive painful dysphagia and a severe hemorrhagic endoscopically impassable esophagitis. She reported to have consumed an unknown liquid from a small flask on a party three weeks ago. Later on, this liquid was identified as a party- and sex-drug known as "Poppers", designed to be consumed by sniffing. On admission she had difficulties in swallowing liquids and even saliva. She had lost 8 kg of weight during the last 3 weeks. Clinical examination revealed tachycardia, a moderate tenderness in the epigastrium and sparse bowel sounds. Investigation and treatment: On endoscopy, there was a severe corrosion injury of the esophagus with a consecutive stenosis at 40 cm ab ore. The stenosis could not be passed even with a 4.9 mm instrument. After initial placement of a feeding tube the stenosis was dilated with Savary-Bougies. In the following years, the patient suffered from recurrent stenosis due to excessive scar formation. Repeated treatment with longitudinal incisions by needle knife and steroid injections improved symptoms to a tolerable degree. 5 years after ingestion, the patient still carries a long segment esophageal scarring with mild to moderate stenosis.


CONCLUSIONS
The party drug Poppers is an organic nitrogen compound that has increasingly come into use over the past years. It may cause severe and life threatening esophageal chemical burn injury. Symptoms of painful dysphagia after intake of an "unknown" liquid party drug should raise the suspicion of an accidental oral ingestion of Poppers.
Klinik für Innere Medizin mit Schwerpunkt Gastroenterologie / Hepatologie, Albertinen-Krankenhaus Hamburg.
Anne Frederike
AF
Wunder
Klinik für Innere Medizin mit Schwerpunkt Gastroenterologie / Hepatologie, Albertinen-Krankenhaus Hamburg.
Michael
M
Oelckers
Klinik für Innere Medizin mit Schwerpunkt Gastroenterologie / Hepatologie, Albertinen-Krankenhaus Hamburg.
Guntram
G
Lock
D000280:Administration, Inhalation; D000284:Administration, Oral; D000293:Adolescent; D003680:Deglutition Disorders / Q000139:chemically induced* / Q000175:diagnosis* / Q000628:therapy; D004106:Dilatation / Q000379:methods; D004940:Esophageal Stenosis / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D004941:Esophagitis / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D004945:Esophagoscopy; D004947:Esophagus / Q000187:drug effects* / Q000293:injuries*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D013287:Illicit Drugs / Q000633:toxicity*; D007899:Leisure Activities; D009566:Nitrates / Q000633:toxicity*; D000439:Pentanols / Q000633:toxicity*; D012008:Recurrence
D013287:Illicit Drugs; D009566:Nitrates; D000439:Pentanols; C036285:amyl nitrate