Improperly Cleaned Beer Taps Cause Caustic Esophageal Injury

Case Overview

This case delves into an incident involving a 50-year-old individual who suffered severe caustic ingestion injuries after consuming beer at a restaurant. The establishment recently reopened following an extended COVID-19 closure. It is alleged that the restaurant failed to adequately clean their beer taps, resulting in residual lye remaining in the dispensing lines.

After being served a pint of beer, the plaintiff immediately experienced burning sensations in their lips, mouth, and throat. This was followed by dysphagia (difficulty swallowing) and heartburn. A subsequent barium swallow test revealed a caustic injury to the esophagus and abnormal and decreased swallowing activity or ability. Since the incident, the patient continues to receive treatment for complications related to this caustic esophageal injury.

Questions to the Gastroenterology expert and their responses

Please describe your experience with caustic esophageal injuries, including the management of patients with this injury and any publications or academic research on the condition or related topics.

With over four decades' experience as a gastroenterologist, I have dealt extensively with patients suffering from caustic esophageal injuries, particularly those caused by lye ingestion.

My tenure as the medical director of a renowned hospital's Endoscopy Center has further enriched my understanding and management of such cases. Additionally, I have been actively involved in esophageal research projects at a leading university.

What is the link between caustic agents, such as sodium hydroxide (i.e. lye), and esophageal injury and subsequent sequela?

Caustic agents like sodium hydroxide are highly corrosive substances that can cause significant damage when they come into contact with body tissues. Ingestion of these substances can lead to immediate chemical burns in the oral cavity, throat, and esophagus.

The severity of the injury can range from mild inflammation to deep ulcers, perforation, or even strictures in the long term.

What is the likely prognosis and related healthcare requirements of patients with significant esophageal injury secondary to caustic substances ingestion?

The prognosis for patients with significant esophageal injuries due to caustic substance ingestion largely depends on the extent and depth of the injury. These patients often require long-term medical care, including nutritional support, pain management, and potentially surgical intervention for complications such as strictures or perforations.

Have you ever reviewed a similar case? If yes, please elaborate.

Yes, I have reviewed similar cases in my career where caustic substances led to severe esophageal injuries. Each case presents unique challenges in patient management and treatment strategies.

About the expert

This expert boasts over four decades of experience in gastroenterology, with a distinguished educational background that includes a BA and MD from a top-tier university. They have completed an esteemed fellowship in gastroenterology after their residency in internal medicine at a renowned cancer center. Currently board-certified in both internal medicine and gastroenterology, this expert has held significant roles such as the director of an Endoscopy Center at a leading university and currently serves as a clinical professor of medicine. Their active participation in several medical societies, coupled with numerous publications on gastroenterology topics, further underscores their expertise in this field.

E-186296

Specialties:

Gastroenterology

About the author

Wendy Ketner, M.D.

Dr. Wendy Ketner is a distinguished medical professional with a comprehensive background in surgery and medical research. Currently serving as the Senior Vice President of Medical Affairs at the Expert Institute, she plays a pivotal role in overseeing the organization's most important client relationships. Dr. Ketner's extensive surgical training was completed at Mount Sinai Beth Israel, where she gained hands-on experience in various general surgery procedures, including hernia repairs, cholecystectomies, appendectomies, mastectomies for breast cancer, breast reconstruction, surgical oncology, vascular surgery, and colorectal surgery. She also provided care in the surgical intensive care unit.

Her research interests have focused on post-mastectomy reconstruction and the surgical treatment of gastric cancer, including co-authoring a textbook chapter on the subject. Additionally, she has contributed to research on the percutaneous delivery of stem cells following myocardial infarction.

Dr. Ketner's educational background includes a Bachelor's degree from Yale University in Latin American Studies and a Doctor of Medicine (M.D.) from SUNY Downstate College of Medicine. Moreover, she is a member of the Board of Advisors for Opollo Technologies, a fintech healthcare AI company, contributing her medical expertise to enhance healthcare technology solutions. Her role at Expert Institute involves leveraging her medical knowledge to provide insights into legal cases, underscoring her unique blend of medical and legal acumen.