Gastrointestinal catastrophe after ingestion of liquid nitrogen-treated candy: a case of Dragon’s breath-induced perforation and postoperative complications

Liquid nitrogen-infused ‘Dragon’s Breath’ snacks have gained popularity despite their potential to cause serious gastrointestinal injury. We report the case of a 14-year-old boy who presented to the emergency department of a tertiary care hospital, two hours after ingestion of ‘Dragon’s Breath’ candy with severe abdominal pain and distension leading to generalized peritonitis and sepsis. Abdominal X-ray showed massive pneumoperitoneum, raising suspicion of hollow viscus perforation. Emergency laparotomy performed, and there was a 3 × 2 cm gastric perforation along the lesser curvature. Primary repair was performed with drain placement, and the initial postoperative course was uneventful, leading to discharge on day 6. Three days later, he re-presented with hematemesis, melena, and haemoglobin of 8 g/dl. Upper gastrointestinal endoscopy showed mild erosive gastritis without active bleeding. This case highlights the significant morbidity associated with liquid nitrogen ingestion and emphasizes the need for safety regulations and postoperative endoscopic follow-up.