Esophageal injury associated with 'black-bean' swallowing: Report of a case

Drug-induced esophageal injury is not uncommonly seen in medical practices, particularly in patient receiving antibiotics, non-steroid anti-inflammatory drug and emeproium bromide. Swallowing 'black-bean', long regarded as one of the important drugs in traditional therapy, can induce esophageal injury as well. Herein, reported for the first time as the present case shows, esophageal injury was induced by swallowing black-bean to treat long term constipation. Clinically, the patient presented with typical symptoms of esophagitis. The panendoscopic findings of esophageal injury showed two circular lesions with clear-cut margins. The outer circle of these lesions was ring-shaped and filled with fibrous exudate. The inner circle was filled with scattered granular exudate and pepper-and-salt in appaarance. The other esophageal mucosa was normal. The panendoscopic and pathological findings in esophageal injury induced by 'black beans' differ from those of other drugs. It is suggested that 'black-bean' be considered in the differential diagnosis of drug-induced esophageal injury.