TABLE 1. Peer-reviewed case reports of LN2 exposure and/or consumption Case # 1 2 Setting & Location School - United States N/A - Australia Case Type Ingestion Ingestion Sex & Age (Years) Details of Incident Clinical Manifestation Reference Male - 15 Subject ingested approximately 30 mL of LN2 while preparing ice cream during a science experiment. * Seizure * Distended abdomen * Massive pneumoperitoneum * Minimal pneumomediastinum * 10 cm perforation (lesser curvature of stomach) * Tissue necrosis near perforation (2) Female - 30 Subject placed cookie coated with LN2 in her mouth and blew on it to produce a " cauldron-like " effect before consuming it. * Mild burning sensation in the mouth * Second-degree intraoral frostbite that resulted in blisters and ulcers in the lower labial mucosa (9) * Severe abdominal pain * Distended abdomen * Shortness of breath * Heart rate: 120 beats/min * Large volume pneumoperitoneum * Abnormal white blood cell count (21,400/μL) * Multiple erythemas (lesser curvature of stomach) * 4 cm perforation (lesser curvature of stomach) (21) (22) 3 Amusement park - Asia Ingestion Male - 13 Subject ingested a cookie that had liquid nitrogen applied to it. 4 N/A - Europe Ingestion Male - 28 * Severe abdominal distension Subject ingested 15 mL * Subcutaneous emphysema of LN2 in an attempt to " produce an impressive burp. " * Gastric rupture (lesser curvature of stomach) 5 6 School - United States Licenced drinking establishment - Europe Subject ingested a smokeemitting blend of orange crystals and LN2 during a science experiment. * Burning sensation in the throat * Severe abdominal pain * Distended abdomen * Shortness of breath * Mild respiratory acidosis * Subcutaneous emphysema * Two small perforations (lesser curvature of stomach) Ingestion Male - 13 Ingestion * Severe abdominal pain * Distended abdomen * Shortness of breath * Elevated white cell count: (30.7 × 109/L) * Tachycardia Subject ingested an * Large volume pneumoperitoneum Female alcoholic beverage that was * Free intra-abdominal fluid - 18 prepared with LN2. * Erythema (fundus of the stomach) * 4 cm perforation (lesser curvature of stomach) * Necrosis and haemorrhage surrounding perforation site * Damage was so severe, a complete gastrectomy had to be undertaken (23) (30) Continued on next page May/June Food Protection Trends 297