Intraoperative Explosion

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Abstract
Since the advent of nonflammable anesthetics, the frequency of intra-operative explosions was reduced markedly. A case is reported that illustrates that explosions can still occur in the operating room and are not always within the control of the anesthesiologist. A patient had a history of esophageal reflux and had extensive oral nutritional supplementation with Ensure prior to surgery. Intubation of the trachea was performed without difficulty. Anesthesia was maintained with 2l O2 and 3l N2O. Surgery proceeded smoothly until the construction of the ileotransverse colon anastamosis. As the stapled colon was opened by electrocautery, a loud explosion occurred, producing a 10-cm rent in the serosa of the colon. The involved colon was resected, and the remainder of the case completed uneventfully. Exploratory laparotomy was performed. Leak of the ileotransverse colon anastamosis and associated left pelvic abscess were found. The abscess was drained and the anastamosis exteriorized. There were no anesthetic related problems. The patient made a satisfactory recovery and was discharged home on the eighteenth postoperative day.

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