
Pisecna_zena
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The look on Takaichi's face as Trump said that:






In this @Gut_BMJ case report by @Mo_Shiha, a 72M with transfusion-dependent bleeding from radiation proctopathy (left photo) underwent flexible sigmoidoscopy for treatment with Argon Plasma Coagulation (APC). Despite having a perfectly clean bowel and use of CO2 insufflation, a loud 'bang' was heard echoing in the endoscopy room, as the APC was applied. The patient experienced sudden, severe abdominal pain, and an urgent CT scan revealed a localized perforation and peritoneal free gas (right photo). The diagnosis was a rare colonic gas explosion triggered by APC. Typically, this devastating complication requires urgent surgery. However, the patient's history of an allogeneic stem cell transplant for leukemia left him with severe bone marrow aplasia, making colonic surgery too risky. He was therefore managed medical with a novel, intensive non-operative approach using antibiotics, parenteral nutrition, and G-CSF. The patient successfully recovered, was discharged after three weeks, and remained bleeding free at 6 months. To the authors’ knowledge, this was the first documented instance of a colonic gas explosion successfully treated without surgery. This is also a reminder that residual stool in the colon can lead to combustible amounts of methane and hydrogen, which can explode when introducing oxygen and heat. gut.bmj.com/content/70/3/4…

















