Preventing Explosion During Argon Plasma Coagulation

The potential for an explosion from a mixture of colonic gases, including hydrogen and methane, when using electrocautery is well known among gastroenterologists. Bowel preparation usually prevents this, although preparation with nonabsorbable sugars such as sorbitol or mannitol can result in high concentrations of explosive gases.

The current report describes an intracolonic explosion that occurred during proctoileoscopy in a 70-year-old woman. The patient had familial adenomatous polyposis, had received a subtotal colectomy with ileal proctostomy 40 years prior, and had previously undergone 12 uncomplicated proctoileoscopies with argon plasma coagulation ablation of rectal and ileal polyps without bowel preparation.

For the current proctoil…