We were confronted recently by an intraluminal colonic explosion during a colonic polypectomy procedure using snare loop electrocautery, probably caused by the presence of hydrogen and/or methane in combustible concentrations. Our patient needed immediate surgery, when several lacerations were found in the colon: a right hemicolectomy and a partial sigmoid resection with primary anastomoses were performed. Colonic bacteria, rests of fecal fluids, certain cleansing solutions, and oxygen insufflation are the main factors involved in cases of colonic explosion. We describe this dramatic event in our patient and discuss whether this complication might be avoidable in the future.
References
-
1
Dafnis G, Ekbom A, Pahlman L. et al .
Complications of diagnostic and therapeutic colonoscopy within a defined population in Sweden.
Gastrointest Endosc.
2001;
53
302-309
-
2
Doniec J M, Lohnert M S, Schniewind B. et al .
Endoscopic removal of large colrectal polyps: prevention of unnecessary surgery?.
Dis Colon Rectum.
2003;
46
340-348
-
3
Bisson B.
Methane gas explosion during colonoscopy.
Gastroenterol Nurs.
1997;
20
136-137
-
4
Bigard M A, Gaucher P, Lassalle C.
Fatal colonic explosion during colonoscopic polypectomy.
Gastroenterology.
1979;
77
1307-1310
-
5
Shinagawa N, Mizuno H, Shibata Y. et al .
Gas explosion during diathermy colostomy.
Br J Surg.
1985;
72
306
-
6
Bond J H, Levitt M D.
Colonic gas explosion - is a fire extinguisher necessary?.
Gastroenterology.
1979;
77
1349-1350
-
7
Monahan D W, Peluso F E, Goldner F.
Combustible colonic gas levels during flexible sigmoidoscopy and colonoscopy.
Gastrointest Endosc.
1992;
38
40-43
-
8
Macfarlane G T, Macfarlane S.
Human colonic microbiota: ecology, physiology and metabolic potential of intestinal bacteria [review].
Scan J Gastroenterol Suppl.
1997;
222
3-9
-
9
Christle S U, Murgatroyd P R, Gibson G R. et al .
Production, metabolism and excretion of hydrogen in the large intestine.
Gastroenterology.
1992;
102
1269-1277
-
10
van Sorge A A, van Nispen tot Pannerden E BLM.
Preoperative total gut cleansing: a simplified protocol. Pharmaceutical and nursing aspects (12 years’ experience).
Pharm Weekblad.
1991;
7
118-124
-
11
Rogers B HG.
Carbon dioxide for colonoscopy.
Gastroenterology.
1980;
78
1659-1660
-
12
Taylor E W, Bentley S, Young D. et al .
Bowel preparation and the safety of colonoscopic polypectomy.
Gastroenterology.
1981;
81
1-4
D. F. G. M. Josemanders, M. D.
Department of Hepatology and Gastroenterology
Rijnstate Hospital · Wagnerlaan 55 · PO Box 9555 · 6800 TA, Arnhem · The Netherlands
Fax: +31-26-3787506·
Email: djosemanders@alysis.nl
