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Acute toxic gastric mucosal damage induced by Lugol’s iodine spray during chromoendoscopy

Lugol’s solution, named after the French Physician JGA Lugol (1786–1851), has a high affinity for glycogen in non-keratinised squamous epithelium.1 Since the 1960s when Lugol’s iodine was first used to investigate oesophageal diseases,2 advances in the field of diagnostic endoscopy have resulted in its increasing use to detect early mucosal abnormalities and to target biopsies from unstained areas.3,4 We have been performing chromoendoscopy using Lugol’s solution for the last 10 years, carrying out 10–15 procedures every year. Here we report the first case of an acute toxic reaction affecting the gastric mucosa.

At gastroscopy of a 67 year old woman with reflux symptoms, a small nodule was noted at the gastro-oesophageal junction together with reflux oesophagitis (LA grade B). Biopsies from the nodule raised the …