Diagnostic dilemma: Liquid-nitrogen-infused cocktail popped a man’s stomach like a balloon
The patient: A 34-year-old man in Mexico
The symptoms: A few seconds after drinking a “smoked” alcoholic drink in a bar, the 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 generalized rather than localized to a single organ, as is often the case in conditions such as appendicitis.
The man told his doctors that the drink he consumed was infused with liquid nitrogen, and doctors suspected the substance ruptured his stomach. When liquid nitrogen heats up and turns into a gas, its volume increases by about 700 times. Because of the huge temperature difference between the liquid, at minus 351 F (minus 196 C), and the man’s body, the substance could have quickly turned into a gas, doctors said. wrote in a report on the man’s caseand thus caused the stomach to burst like an over-inflated balloon.
To assess whether there was a perforation in the man’s stomach, doctors listened for signs of air while tapping his abdomen. Certain areas of the abdomen, such as the stomach, normally contain air and produce a high-pitched “tympanic” sound when tapped. On the other hand, more solid or fluid-containing organs, such as the liver located above the stomach, produce a low, “dull” sound. In this patient, however, the entire abdomen was tympanic, including the region above the stomach.
The diagnosis: Next, doctors looked at the patient’s soft tissues using CT scans. From these scans, they discovered a layer of nitrogen gas trapped in the patient’s abdomen, just above his stomach and below his lungs – a condition known as pneumoperitoneum. This confirmed that the gas had ruptured the man’s stomach and accumulated above it.
The treatment: 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 sutured and sealed the 3-centimeter-wide hole, using a piece of fatty tissue from elsewhere in the man’s abdomen.
The patient recovered quickly and was discharged three days later after demonstrating he could tolerate a liquid diet, doctors said in the report.
What makes the case unique: In addition to bursting the stomach, liquid nitrogen that is consumed before completely evaporating from food and drinks can cause permanent cold burns in 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 thought it was because of the “Leidenfrost effect“, a physical phenomenon that describes how a liquid behaves when it encounters a surface significantly hotter than its boiling point. The outermost layer of the liquid instantly vaporizes, temporarily shielding the hot surface (in this case, human tissue) from the remaining cold liquid. This insulating layer of gas may explain why the liquid nitrogen did not burn the man as it passed through his esophagus.
Liquid nitrogen is often used in meal preparation. For example, flash freezing meat with this substance preserves its protein structure and retains moisture more effectively than other freezing methods. It can also retain fats in seafood and help them retain their flavor. However, by the time these foods reach the table, they are safe to eat because the nitrogen has completely escaped.
Topping foods and drinks with liquid nitrogen for their smoky, theatrical appearance can be dangerous if impatient gourmands consume these foods before the liquid is completely vaporized. It is therefore best to wait until the cloud dissipates. Liquid nitrogen is often used to create an illusion of smoke. close food, but not inside, thereby minimizing the risk of injury.
For more intriguing medical cases, check out our Diagnostic Dilemma Archives.
This article is for informational purposes only and is not intended to offer medical or food safety advice.
