English

Abstract

Most of recto-sigmoid injuries occur following impalement injuries by a variety of objects. Perforation caused by a Liquefied Petroleum Gas tube is not reported in literature. We report one such interesting case in which there was free LPG in peritoneal cavity as a result of perforation. It caught fire during opening of peritoneal cavity. CASE SUMMARY: A 40 year old male patient was admitted in emergency with history of pain abdomen, distension & vomiting of 6 hours duration. He was on treatment for a psychotic illness. He had a quarrel with his neighbors, who forced way in his house and four of them beat him. They forcibly introduced a pipe into his rectum and switched on the knob, following which he developed pain abdomen. He was rushed to emergency department. On examination, he was found to have distension of the abdomen without any guarding or rigidity. A gentle proctoscopy revealed congested rectum with some bleeding. Erect film of the abdomen revealed free air under the diaphragm. Abdomen was explored with midline incision. While electric cautery was being used to open the linea alba and peritoneum, a sudden flash of fire came towards surgeon's face, which surprised us all. The fire got extinguished within fraction of seconds without burning the skin of the patient and the operating team. There was a contusion along with color changes at the top of the sigmoid loop extending upto 5 cm, with doubtful viability and perforation of 1.5 -2 cm size in its center (Figure 1). In view of gross fecal contamination and contusion of sigmoid colon with perforation, sigmoid was excised, rectal stump was closed & an end colostomy was done.