Key result
Intraoperative injection of 60 mL of 3% hydrogen peroxide into an enterocutaneous fistula resulted in a venous oxygen embolism in a 66-year-old man, who recovered without long-term sequelae.
Case Report (n=1)
No
Injection of hydrogen peroxide into fistula tracts can cause potentially fatal venous oxygen embolism.
Alerts to embolism risk with hydrogen peroxide in fistulas; leaves open need for safer alternatives and incidence data.
In Brief We report a venous oxygen embolism that occurred in a 66-yr-old man after 60 mL of 3% hydrogen peroxide was injected into a perianal fistula intraoperatively to locate its internal opening. The diagnosis was made after detecting hypoxemia, decreased end-tidal carbon dioxide tension, systemic hypotension, increased central venous pressure, and a new heart murmur. The patient recovered quickly and had no long-term sequelae. Oxygen embolism is a potentially fatal complication that can develop when hydrogen peroxide is used near venous spaces, and clinicians should be aware of the potential dangers when using this seemingly innocuous chemical. IMPLICATIONS: Hydrogen peroxide is used intraoperatively and perioperatively for the identification of fistula tracts. A venous oxygen embolism occurred in a 66-yr-old man after the intraoperative injection of 60 mL 3% hydrogen peroxide into an enterocutaneous fistula. The relevant aspects of the diagnosis and treatment of oxygen embolism are discussed.
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Jones et al. (2004) conducted a case report in Enterocutaneous fistula (n=1). 3% hydrogen peroxide was evaluated on Venous oxygen embolism. Intraoperative injection of 60 mL of 3% hydrogen peroxide into an enterocutaneous fistula resulted in a venous oxygen embolism in a 66-year-old man, who recovered without long-term sequelae.
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