Explosion during surgery for gastric outlet obstruction

Explosion During Diathermy Gastrotomy in a Patient With Carcinoma of the Antrum

“…Our patient had upper gastrointestinal obstruction, like other reported cases of gas explosion 1,2,4 . Under normal conditions, hydrogen, methane and oxygen gases cannot reach levels of concentration capable of becoming explosive 1 .…”

“…The first reported case of an explosion of gas during a gastrointestinal procedure took place during sigmoidoscope electrosurgical polypectomy in 1944 1 . Since then, several similar cases have been reported during colonoscopic procedures 2,3 . Gas explosion during diathermy gastrotomy is very rare, and we have found only two cases in the literature 1,4 .…”

“…Most of these are seen during surgery or endoscopic interventions of the colon and rectum 1,5 . Mills and Jones reported an explosion in a patient undergoing vagotomy and pyloroplasty while the duodenum was being incised – the patient developed a tear at the posterior wall of the duodenum 2 . A gas explosion of the jejunum was reported in 1982 6 .…”

“…Another possible cause for the explosion is anaesthetic gases. The mixture of 60% nitrous oxide, 30% oxygen and isoflurane is not flammable until the isoflurane concentration reaches about 7% 2 . Reier and Wu demonstrated that cyclopropane introduced into the stomach remains explosive for at least 90 minutes.…”