Small bowel explosion: a complication of strictureplasty

Area of Science:

• Gastroenterology
• Surgical Innovation
• Patient Safety

Background:

• Electrocautery is a common surgical tool used for cutting and coagulation.
• Intestinal explosions are a rare but severe complication associated with electrocautery use.
• Chronic obstructing Crohn's disease presents unique surgical challenges.

Observation:

• A case of small bowel explosion during strictureplasty for Crohn's disease is presented.
• This is the third reported instance of electrocautery-induced small bowel explosion.
• The explosion occurred during a surgical procedure on a patient with severe Crohn's disease.

Findings:

• The patient experienced a small bowel explosion during strictureplasty.
• Previous literature documented only two similar cases of electrocautery-related small bowel explosions.
• The event highlights a potentially catastrophic risk associated with electrocautery in specific surgical contexts.

Implications:

• Proximal decompression of the bowel before incision is recommended to mitigate explosion risk.
• Avoiding electrocautery in certain situations may be a prudent measure to prevent this complication.
• Enhanced awareness and procedural modifications are crucial for improving patient safety in complex gastrointestinal surgeries.