Corrosive esophagitis is mostly due to ingestion of acid and alkaline medicines, and one due to organic solvent is very rare. We have recently experienced one patient with esophageal ulcer caused by a binding agent containing toluene.
A 34-year-old man was found lying after ingestion of a binding agent containing toluene, and admitted to the psychiatry ward. He complained of retrosternal pain when eating foods, and vomitted coffee ground material on Aug 16. Endoscopy was carried out, and an ulcer of the esophagus was found ; it was covered by a broad band of white coat in the region 33 cm from the upper teeth to the EC junction.
There were luekocytosis and increased CRP suggestive of inflammation. Serum levels of total protein were reduced suggesting a reduced nutrition state. Biopsy histology of the esophagus demonstrated abundant capillaries, proliferating fibroblasts and inflammatory cell infiltration. A diagnosis of esophageal ulcer of Rosenow grade III was made. He was treated canservatively with an H2 recepter antagonist and recovered almot fully on Sept 21.
It is generally believed that organic solvent is not very damaging to the esophageal mucosa, but toluene, has a strong central nerve suppressing effect, leading sometime to death. In patients who have ingested an organic solvent, endoscopy is recommended because of possible corrosive esophagitis.
