Free gas in the peritoneal cavity: the final hazard of diathermy

Fires and explosions in the operating theatre are rare events, but are devastating in terms of structural damage to the equipment in theatres and to human lives. Fuel, oxygen, and source of ignition are the three factors causing explosion. Explosion during emergency laparotomy for perforated bowel has not been reported in the literature. In the case reported here, fuel in the form of free gas came from the perforated stomach, after cardiopulmonary resuscitation. Oxygen used during cardiopulmonary resuscitation had entered the peritoneal cavity through the perforation. The source of ignition was diathermy. It was fatal.