Diathermy induced gas explosion during laparotomy: a case report

Diathermy-induced explosions in the gastrointestinal tract can occur during laparotomy and can be fatal. Hydrogen and methane are the most common flammable gases that are produced in the gastrointestinal tract. A 35-year-old male was referred to a tertiary hospital with abdominal pain after being assaulted and stabbed in the abdomen. He presented with a 2-cm wound in the midline below the xiphoid process and with an omentum protruding through the wound. Explorative laparotomy was done to repair the jejunal perforation, but a gastric blast occurred, making more than half of the gastric pouch non-viable. The operation was converted to a near-total gastrectomy with Roux-en-Y gastrojejunostomy. During open abdominal surgery, fires and explosions can occur. Precautions should be taken during open abdominal surgery to reduce the risk of explosions, such as allowing combustible gases to exit the cavity before using diathermy.