Dutzende Menschen sind bei der heftigen Explosion im Zentrum von Paris verletzt worden. Bitte wählen Sie einen Newsletter aus. Die Polizei geht von einem Gasleck als Ursache aus. Significantly higher counts of gas-producing E.
In conclusion, we recommend the following to avoid colonic gas explosion during colonoscopy with electrocautery: 1 Cleansing solution containing mannitol[ 3 , 8 , 19 ] or other malabsorbed carbohydrates e. Bitte versuchen Sie es erneut. Methane gas explosion during colonoscopy. Get the latest breaking news delivered straight to your inbox.
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Am Vieles sprach für einen Unfall. In these cases, the used enema did not contain any fermentable agents and the extension of colonic preparation was thought to be the initiating factor in this complications.
Therapeutic colonoscopy with electrocautery is widely used around the world. Adequate paros cleansing is considered a crucial factor for the safety of this procedure. This complication is the result of an accumulation of colonic gases to explosive concentrations, but may be prevented by meticulous bowel preparation.
The purpose of this review is to discuss the indications and the types of bowel preparations for therapeutic colonoscopy, and to contribute recommendations for the adequate bowel preparation for colonoscopy with electrocautery. Among complications that have pariw reported, gas explosion is rare, but its nature could be dramatic, as perforation could complicate colonic explosion and urgent surgery is needed. Three factors are necessary to trigger an explosion of colonic gases: presence of combustible gases hydrogen, methane produced by the fermentation of non-absorbable carbohydrates in the colon by the colonic Gasezplosion, presence of combustive gas oxygenand application of Gasexplosion paris heat source electrocautery or argon plasma coagulation [ 1 - 3 ].
Only hydrogen and methane are combustible[ 4 ]. They are produced in the colonic lumen from fermentation of non absorbable e. Following bowel preparation with Niurka marcos net worth combination of clear liquids, cathartics, and enemas, mean concentration of hydrogen 0.
Thus, safety of therapeutic colonoscopy could be in part related Gasexploxion the quality of preparation before the procedure. An accumulation of colonic gas to potentially explosive concentrations due to poor colon preparation is considered Marianne rosenberg nackt initiating factor in the complication of colonic gas explosion.
Therefore, quality of bowel preparation as well as type of preparation and dietary restrictions are all essential for an uneventful therapeutic colonoscopy. The main indication for application of electrosurgical energy is snare colonoscopic polypectomy with blended or pure coagulation current[ 10 ]. Electrosurgical generators are used to supply electrical energy to endoscopic accessories. Electrosurgical generators may supply two types of circuits, monopolar and bipolar.
Argon plasma delivered through a flexible probe passed through the accessory channel and allows treatment paria a large area quickly[ 13 ]. The selection of purgative used for colon preparation is an important factor that makes the bowel safe for therapeutic procedures. Earlier than 's, mannitol was considered as the reference agent for colonic preparation. Explosions during therapeutic colonoscopy have been reported after mannitol preparation and its use is now avoided as cleansing colonic solution[ 1 - 3515 - 17 ].
Use of oral mannitol increased hydrogen and methane excretion[ 35918 - 19 ]. Aspiration of colonic gas at the time of colonoscopy showed that mean intracolonic hydrogen concentration was significantly higher after mannitol than after castor oil. Fermentation of mannitol by E. Significantly higher counts of gas-producing E.
Therefore, the use of antibiotics prior to therapeutic Indianer beim sex could be a measure that Gasexplosion paris lower the load of intracolonic bacteria.
An alternative approach to reduce the risk of explosion of colonic gases if mannitol preparation is used before electrocautery is insufflation of an inert gas such as carbon dioxide instead of air[ 322 ]. Sincea major progress occurred with new agents, such as polyethylene glycol electrolyte lavage solution Gasexploson and oral sodium phosphate NaP Nackt im big brother. Several studies agree that these agents provide a climate safe for electrocautery during colonoscopy by decreasing the concentrations of combustible gases[ 1423 - 26 ].
The highest hydrogen and methane concentrations after a PEG-ELS preparation are well below the combustible level[ 26 ]. A recent report described a case of colonic gas explosion in a patient that underwent bowel preparation with a polyethylene glycol solution containing sorbitol[ 27 ]. Sorbitol is an important carbohydrate that is daily Gasexplosion paris in humans diet. Thus, fermentation of this malabsorded carbohydrate by colonic bacteria Gasecplosion result in raised combustible gas concentrations in the colon and explain the explosion that occurred in the above mentioned case report[ 27 ].
For lesions that need electrocautery and are located up to the level of sigmoid colon, a Gasexplosion paris sigmoidoscopy with enema preparation pzris the procedure of choice by the majority of gastroenterologists.
However, pariz have reported cases of gas explosion in patients prepared by enemas[ 29 - 31 ]. In these cases, the used enema did not contain any fermentable Gasecplosion and the extension of colonic preparation was thought to be the initiating factor in this complications.
Due to the partial colonic preparation, presence of residual stools above the lesions could enhance gas production and explain gas explosion. In a prospective study, sixty patients were evaluated to compare the presence of the combustible gases hydrogen and methane during colonoscopy after a PEG-ELS preparation and flexible sigmoidoscopy after phosphosoda enemas alone[ 32 ].
Patients had combustible parus even after air insufflation during sigmoidoscopy and parix possibility of explosion was clinically significant. Another important observation of this elegant study was that even segments of colon with excess retained stools did not have combustible levels of these two gases. It seems that insufflation of air during colonoscopy equalizes the distribution of combustible gases, overcoming the compartmentation of the colon. All three explosions after enema preparation occurred in patients with persistent solid stool above the coagulated lesions.
Thus, the presence of stools could constitute the main risk for the colonic explosion. The search terms included were combinations of "colonic explosion" or "gas explosion" with "surgery", "electrocautery", "polypectomy", and "argon plasma coagulation".
Eleven cases of gas explosion during surgery[ 21633 - 39 ] and 9 cases during colonoscopic procedures have been published. Argon plasma coagulation provided the initiating heat source in five of the nine colonoscopic cases[ 29 - 31 ], whereas the remaining four cases were associated with endoscopic polypectomy[ 1151727 ].
Recently, we also experienced a case of colonic explosion during an argon plasma coagulation procedure for postradiation colitis.
Although seven successive, uneventful sessions of argon plasma coagulation were performed with enema preparation, Gasexllosion explosion without colonic perforation occurred upon finishing the last procedure. Perforation was observed in all of the four polypectomy cases[ 1151727 ], in two cases using argon plasma coagulation[ 2931 ], and in three cases during electrosurgery[ 233 - 34 ].
One of the four perforations during polypectomy was fatal[ 1 ]. Bowel preparation by ingestion of a mannitol solution was used in 14 cases and of a cleansing solution containing sorbitol in one case[ 27 ]. Preparation by enemas containing no fermentable agent was used in South park nackt five cases treated with argon plasma coagulation for post-radiation colitis[ 29 - 31 ].
Colonic gas explosion is a rare, but potentially serious complication during colonoscopy with electrocautery. Accumulation of colonic combustible gases at potentially explosive concentrations due to poor colon preparation is the cause of gas explosion. Cleansing purgatives PEG, NaP that make the bowel safe for electrocautery by decreasing the concentrations of the combustible gases are adequate for colon preparation.
Argon plasma coagulation carries an increased risk of explosion during sigmoidoscopy following enemas, and it should only be performed after full bowel preparation. In conclusion, we recommend the following to avoid colonic gas explosion during colonoscopy with electrocautery:. National Center for Biotechnology InformationU.
Journal List World J Gastroenterol v. World J Gastroenterol. Published online Oct Author information Article notes Copyright and License information Disclaimer. Author contributions: All authors contributed equally to the work. All rights reserved. This article has been cited by other articles in PMC. Abstract Therapeutic colonoscopy with electrocautery is widely used around the world.
Keywords: Colonic gas explosion, Electrocautery, Therapeutic polypectomy, Argon plasma coagulation, Polypectomy. Electrosurgical generators Electrosurgical generators are used to supply electrical energy to endoscopic accessories. Partial bowel preparation by enemas For lesions that need electrocautery and are located up to Gazexplosion level of sigmoid colon, a Louane nackt sigmoidoscopy with enema preparation is the procedure of choice by the majority of gastroenterologists.
Open in a separate window. Figure 1. In conclusion, we recommend the following to avoid colonic gas explosion during colonoscopy with electrocautery: 1 Cleansing solution containing mannitol[ 3 Gasexplosoin, 819 ] or other malabsorbed carbohydrates e. References 1. Fatal colonic explosion during colonoscopic polypectomy.
Colonic explosion during an endoscopic electrocoagulation after preparation with mannitol. Gastroenterol Jordan carver sex movie Biol. Bowel preparation and the risk of explosion during colonoscopic polypectomy. Volume, composition, and source of intestinal gas. Colonic gas explosion--is a fire extinguisher necessary?
Coincidental malabsorption of lactose, fructose, and sorbitol ingested at low doses is not common in normal adults. Dig Dis Sci. Levy EI. Explosions during lower bowel electrosurgery. Am J Surg. The explosive potential of colonic gas during colonoscopic electrosurgical polypectomy. Surg Gynecol Obstet.
Bowel preparation and the safety of colonoscopic polypectomy. Electrosurgical generators: MAY Gastrointest Endosc. The argon plasma coagulator: February Tucker RD. Principles of electrosurgery. In: Sivak MV, editor. Gastroenterologic endoscopy. Philadelphia: WB Saunders; Farin G, Grund KE. Technology of argon plasma coagulation with particular regard to endoscopic applications. Endosc Surg Allied Technol. Waye J.
How I use the argon plasma coagulation. Clin Perspect Gastronetrol.
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Colonic gas explosion during therapeutic colonoscopy with electrocautery. Gasexplosion paris
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