DOI: https://doi.org/10.36347/sasjs.2025.v11i05.015

Pages: 530-534

Intraoperative gas explosions during digestive surgical emergencies are a rare occurrence. They occur when certain combustible intestinal gases reach a certain concentration. They can be fatal for the patient-surgeon couple. Purpose: To study the contributing factors and morbidity and mortality through these three cases. Observations: We present three adults men admitted for peritoneal syndrome in two cases and a complex anal fistula in one case. Two patients presented with abdominal distension, respectively after abdominal contusion in an intoxicated patient and the other for colonic perforation following a sigmoid colon volvulus. Exploratory laparotomy was indicated in two cases. The detonation followed by a blue flame occurred upon opening the peritoneal cavity in two cases and during fistulotomy after flatulence in one case. The contributing factors were predominantly intraperitoneal gas hyperconcentration (accidental or physiological) combined with the use of an electric scalpel. The lesions were characterized by gastric and visceral explosion with cardiac arrest and subsequent death in one case, and a posterior perineal burn. One patient was unharmed. Conclusion: Electrocautery should be avoided in cases of emergency abdominal hyperpressure.