Rationale and objectives: A patient was encountered with a long esophageal stricture that may have been caused by glutaraldehyde-contaminated endoscopic equipment. An in vivo study of laboratory rats was performed to determine the effect of glutaraldehyde exposure on the esophagus.
Methods: Ten laboratory rats were divided into five groups that received daily gavage of the esophagus with either 3.2% glutaraldehyde solution (treated rats) or 1 mL of normal saline (control rats) for varying durations. After the rats were killed, histologic sections from the esophagus were reviewed in a blind fashion. The degree of inflammatory infiltrate at the gastroesophageal junction was quantified as mild, moderate, or marked.
Results: Histologic examination revealed greater neutrophilic infiltration in the submucosa of the gastroesophageal junction in three of four glutaraldehyde-treated rats compared with controls. Treated rats also had evidence of segmental esophageal vasculitis not seen in any of the controls. Both controls and treated rats had areas of myositis and myonecrosis within the esophagus.
Conclusion: Exposure to glutaraldehyde has a toxic effect on the rat esophagus. Glutaraldehyde-induced esophageal injury should therefore be considered in patients who develop esophagitis or esophageal strictures after upper endoscopy.