Abstract
Background
The ghost pepper, or “bhut jolokia,” is one of the hottest chili peppers in the world.
Ghost peppers have a measured “heat” of > 1,000,000 Scoville heat units (SHU), more
than twice the strength of a habanero pepper. To our knowledge, no significant adverse
effects of ghost pepper ingestion have been reported.
Case Report
A 47-year-old man presented to the Emergency Department (ED) with severe abdominal
and chest pain subsequent to violent retching and vomiting after eating ghost peppers
as part of a contest. A subsequent chest x-ray study showed evidence of a left-sided
pleural effusion and patchy infiltrates. A computed tomography scan of the abdomen
and pelvis showed pneumomediastinum with air around the distal esophagus, suggestive
of a spontaneous esophageal perforation and a left-sided pneumothorax. The patient
was intubated and taken immediately to the operating room, where he was noted to have
a 2.5-cm tear in the distal esophagus, with a mediastinal fluid collection including
food debris, as well as a left-sided pneumothorax. The patient was extubated on hospital
day 14, and was discharged home with a gastric tube in place on hospital day 23.
Why Should an Emergency Physician Be Aware of This?
Spontaneous esophageal rupture, Boerhaave syndrome, is a rare condition encountered
by emergency physicians, with a high mortality rate. This case serves as an important
reminder of a potentially life- threatening surgical emergency initially interpreted
as discomfort after a large spicy meal.
Keywords
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References
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Article info
Publication history
Published online: September 29, 2016
Accepted:
May 5,
2016
Received in revised form:
April 6,
2016
Received:
January 21,
2016
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
