Combustion of pneumoperitoneum: a rare danger in the operating room

Fire or combustion occurring during laparotomy is an uncommon and potentially hazardous event that can be precipitated by the use of surgical energy devices in the presence of enteric gases or exogenous materials present in the abdomen such as alcohol. Oxygen necessary for a combustive event can be increased in the setting of a proximal enteric injury and with higher concentrations of inspired oxygen during anaesthesia. We report on a case of combustion on entry to the abdomen using monopolar diathermy during exploratory laparotomy for gastric antral perforation in the presence of alcohol and enteric gases.