Sindani Martin, Lugwaja Paul William Itule, Ngowi Novath
Department of Surgery, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania.
J Surg Case Rep. 2023 Aug 9;2023(8):rjad460. doi: 10.1093/jscr/rjad460. eCollection 2023 Aug.
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.
剖腹手术期间可发生透热疗法引起的胃肠道爆炸，且可能致命。氢气和甲烷是胃肠道产生的最常见可燃气体。一名35岁男性在腹部遭袭击和刺伤后因腹痛被转诊至一家三级医院。他在剑突下中线处有一个2厘米的伤口，大网膜从伤口处突出。进行了剖腹探查术以修复空肠穿孔，但发生了胃爆炸，导致超过一半的胃袋无法存活。手术改为近乎全胃切除术并进行Roux-en-Y胃空肠吻合术。在开腹手术期间，可能会发生火灾和爆炸。开腹手术期间应采取预防措施以降低爆炸风险，例如在使用透热疗法之前让可燃气体排出体腔。
