Flammable gases are sometimes present in the colon. If enough flammable gas is present then there can be an explosion if an ignition source is available.
Colonic gases that can ignite:
(1) hydrogen gas
(2) methane
Ignition sources include:
(1) electrocautery units
(2) laser
(3) argon plasma coagulation (APC)
Complications may include:
(1) bowel perforation
(2) thermal injury to bowel wall
(3) accidental injury caused when the endoscopist jumps back
The risk for explosion can be reduced by:
(1) Do not use a malabsorbed carbohydrate (mannitol, etc) for bowel preparation.
(2) Do not use a standard enema as bowel preparatin for sigmoidoscopy.
(2) Perform complete colonic cleansing with oral polyethylene glycol (PEG) or sodium phosphate prior to colonoscopy.
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