patient: 34 year old man in Mexico
Symptoms: Within seconds of drinking a “smoky” alcoholic drink at a bar, a man felt intense pain in his stomach.
The patient reported feeling discomfort and tenderness when doctors touched his abdomen in four places. This revealed that the pain was widespread rather than localized to one organ, as is often the case with similar conditions appendicitis.
The man told his doctors that the drink he drank was filled with liquid nitrogen, and doctors suspected that the substance had ruptured the man’s stomach. When liquid nitrogen is heated and turns into a gas, it increases its volume by about 700 times. Given the huge temperature difference between the liquid at minus 351 F (minus 196 C) and the man’s body, the substance could have quickly swelled into a gas, doctors say he wrote in the man’s case reportand so the stomach burst like an overblown balloon.
To determine if there was a perforation in the man’s stomach, doctors listened for signs of air while tapping on his abdomen. Certain areas of the abdomen, such as the stomach, normally contain air and make a high-pitched “tympanic” sound when tapped. In contrast, more solid or fluid-containing organs, such as the liver sitting on top of the stomach, produce a low, “dull” sound. However, in this patient, the entire abdomen was tympanic, including the area above the stomach.
Diagnosis: Next, the doctors observed the patient’s soft tissue using CT images. From these scans, they discovered a layer of trapped nitrogen gas in the patient’s abdomen, just above his stomach and below his lungs – a condition known as pneumoperitoneum. This confirmed that the gas had penetrated the man’s stomach and pooled above him.
Therapy: Doctors made a small keyhole incision in the patient’s abdomen, which released the trapped nitrogen gas. They then inserted a laparoscope – a thin tube with a camera – through the keyhole and into the stomach to find and repair the perforation. Finally, they stitched and sealed the 1.2-inch-wide (3-centimeter) opening using a piece of fatty tissue from elsewhere in the man’s abdomen.
The patient recovered quickly and was discharged three days later after proving that he could tolerate a liquid diet, doctors said in a report.
What makes the case unique: In addition to bursting the stomach, liquid nitrogen consumed before it completely evaporates from food and drink can cause permanent cold burns to the body because the substance freezes water in human cells and damages tissue.
Fortunately, the patient did not experience any cold burns in the mouth, esophagus or stomach. Doctors believed it was due to “Leidenfrost effect,” a physical phenomenon that describes how a liquid behaves when it encounters a surface significantly hotter than its boiling point. The outer layer of liquid vaporizes immediately, temporarily shielding the warm surface (in this case, human tissue) from the remaining cold liquid. This insulating layer of gas may explain why liquid nitrogen did not burn a person when passing through the esophagus.
Liquid nitrogen is often used food preparation. For example, flash freezing meat with this substance preserves its protein structure and locks in moisture more effectively than other freezing methods. It can also preserve the fats in seafood and help them retain their flavor. However, by the time these foods hit the dinner table, they are safe to eat because the nitrogen has completely bubbled up.
Garnishing food and drink with liquid nitrogen for its smoky, theatrical appearance can be dangerous if impatient foodies consume the stuff before the liquid has completely evaporated. Therefore, it is best to wait until the cloud clears. Liquid nitrogen is often used to create the illusion of smoke at food, but not in it, thus minimizing the risk of injury.
For more interesting medical cases, check out ours Archives of the diagnostic dilemma.
This article is for informational purposes only and is not intended to provide medical or food safety advice.
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