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Burns of the esophagus are usually caused by chemical substances. In our report, we present a case of burn injury burn caused by swallowing boiling water under the influence of controlled substances. During the initial diagnostic procedures, a CT scan was performed. In contrast, in the later on performed gastroscopy, the CT scan revealed intramural and free air. A conservative treatment was started including parenteral nutrition, application of a nasogastric tube, and administration of PPIs. We conclude that for diagnosing the extend of a burn of the esophagus, a CT scan should be performed in addition to endoscopic procedures.