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The ingestion of lye is the most common cause of benign stricture of the esophagus, and a small amount of a dilute solution of this substance will usually produce marked scarring in that organ.
When the solution is concentrated and has been taken with suicidal intent, the entire esophagus may be practically destroyed with resulting mediastinitis and death, and weaker solutions taken in smaller amounts may produce sufficient ulceration of the esophagus to be followed by the formation of a periesophageal abscess. If the inflammatory process has extended beyond the wall of the esophagus, the initial passage of dilating sounds may rupture the wall of the abscess and produce general mediastinitis with fatal termination. Fortunately, this complication rarely arises, and it has never been my experience to perforate a benign esophageal stricture resulting from lye after the first dilatation. It is not difficult to understand
PORTER P. VINSON. SPONTANEOUS PERFORATION OF BENIGN STRICTURE OF THE ESOPHAGUSREPORT OF A CASE. Arch Otolaryngol. 1932;16(3):329–330. doi:10.1001/archotol.1932.00630040339002