case_images: PMC8286424_01
case_images: Images from early performed gastroscopy for patients P1-P4. Esophageal lesions are documented in the first row, the following rows show lesions in the stomach. The white arrow (P1b) marks a focal necrosis (approximately 3 cm) in the antrum, which is shown in more detail in P1c (Zargar 3A). The other patients had ulcerations without necrosis (Zargar 2). The asterisk (*) marks the small curvature.
case_images: CEG-14-303-g0001.jpg
case_images: PMC8286424_01_CEG-14-303-g0001.jpg
case_images: f0001
case_images: During EGD, lesions were most pronounced in the distal esophagus (Figure 1, first row). In the stomach, lesions were distributed mainly along the small curvature (Figure 1, second and third row).
case_images: Correlation of the toxin dose with the severity of the gastroesophageal lesions and the duration of the inpatient stay. The black circles ( ) indicate the duration of the inpatient stays, whereas the rectangles show the corresponding Zargar classification.
case_images: CEG-14-303-g0002.jpg
case_images: PMC8286424_01_CEG-14-303-g0002.jpg
case_images: f0002
case_images: Interestingly, the degree of mucosal damage correlated with the amount of toxin ingested: while the two patients that drank 1/4 of a shot glass or less (P3+P4) had less pronounced lesions than the patient with half a shot (P2), the patient with a full shot glass (P1) had even necrotic lesions (Figure 2). The duration of inpatient stay varied between 1 and 9 days (P1: 9 days, P2: 5 days, P3: 3 days, P4: 1 day) and tended to be longer in patients with more pronounced lesions (Figure 2).