{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T10:14:55Z","timestamp":1792318495900,"version":"4.4.0"},"reference-count":9,"publisher":"BMJ","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1984,4]]},"abstract":"<jats:p>Concentration of oxygen, methane, and hydrogen were measured in intracolonic gas samples aspirated through the colonoscope at the time of colonoscopy from 46 patients. Of the above patients 20 prepared either with mannitol (n = 10) or with castor oil (n = 10) had the instrument passed to the caecum without air insufflation or suction. After mannitol, mean intracolonic hydrogen concentration (4.07%) was significantly higher (p less than 0.001) than after castor oil (0.51%). Mean oxygen and methane concentrations were approximately similar. Potentially explosive concentrations of hydrogen (greater than 4.1%) and or methane (greater than 5%) were present in 6\/10 patients given mannitol and 2\/10 patients given castor oil. Nevertheless only one patient from each group had coexisting oxygen concentrations of more than 5% producing thus a combustile mixture. Routine colonoscopy (using air insufflation and suction) was performed in 26 patients prepared with mannitol. Mean intracolonic hydrogen and methane was 0.63% and 0.88% respectively. The highest recorded concentration of hydrogen was 2.6%, and of methane 2.1%, while all patients had oxygen concentrations of more than 5%. It is suggested, therefore, that routine insufflation and suction before colonoscopic electrosurgical polypectomy should result in safe levels of these gases. The remote possibility of pockets of undiluted gas in explosive concentration, however, indicates the use of an inert gas such as carbon dioxide if mannitol preparation is used before electrosurgery.<\/jats:p>","DOI":"10.1136\/gut.25.4.361","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"361-364","source":"Crossref","is-referenced-by-count":58,"title":["Bowel preparation and the risk of explosion during colonoscopic polypectomy."],"prefix":"10.1136","volume":"25","author":[{"given":"A","family":"Avgerinos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"Kalantzis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Rekoumis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Pallikaris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G","family":"Arapakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"Kanaghinis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1984,4,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1016\/0002-9610(52)90078-0","article-title":"Explosion in the colon during electrodesiccation of polyps","volume":"84","author":"HG, I.Carter","year":"1952","unstructured":"I Carter HG. Explosion in the colon during electrodesiccation of polyps. Am J Surg 1952; 84: 514-7.","journal-title":"Am J Surg"},{"key":"ref_2","first-page":"41","article-title":"Explosion of hydrogen gas in the colon during proctosigmoidoscopy","volume":"23","year":"1956","unstructured":"Bond JH, Levy M, Levitt MD. Explosion of hydrogen gas in the colon during proctosigmoidoscopy. Gastrointest Endosc 1956; 23: 41-2.","journal-title":"Gastrointest Endosc"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1084\/jem.133.3.572","article-title":"Factors influencing pulmonary methane excretion in man","volume":"133","year":"1971","unstructured":"Bond JH, Levitt MD. Factors influencing pulmonary methane excretion in man. J Exp Med 1971; 133: 572-88.","journal-title":"J Exp Med"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1056\/NEJM196907172810303","article-title":"Production and excretion of hydrogen gas in man","volume":"281","author":"Levitt, MD","year":"1969","unstructured":"Levitt MD. Production and excretion of hydrogen gas in man. N Engl J Med 1969; 281: 122-7.","journal-title":"N Engl J Med"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1016\/0002-9610(54)90270-6","article-title":"Explosions during lower bowel electrosurgery. A method of prevention","volume":"88","author":"El, Levy","year":"1954","unstructured":"Levy El. Explosions during lower bowel electrosurgery. A method of prevention. Am J Surg 1954; 88: 754-8.","journal-title":"Am J Surg"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/0016-5085(81)90643-0","article-title":"Bowel preparation and the safety of colonoscopic polypectomy","volume":"81","author":"Taylor, E.W.; Bentley, S.; Youngs, D.; Keighley, M.R.B.","year":"1981","unstructured":"Taylor EW, Bentley S, Youngs D, Keighley MRB. Bowel preparation and the safety of colonoscopic polypectomy. Gastroenterology 1981; 81: 1-4.","journal-title":"Gastroenterology"},{"key":"ref_7","first-page":"634","article-title":"Potentially explosive colonic concentrations of hydrogen after bowel preparation with mannitol","volume":"1","author":"SJ, La Broy; A, Avgerinos; CL, Fendick; CB, Williams; JJ, Misiewicz","year":"1981","unstructured":"La Broy SJ, Avgerinos A, Fendick CL, Williams CB, Misiewicz JJ. Potentially explosive colonic concentrations of hydrogen after bowel preparation with mannitol. Lancet 1981; 1: 634-6.","journal-title":"Lancet"},{"key":"ref_8","first-page":"301","article-title":"Explosion colique au cours d'une electrocoagulation endoscopique apres preparations au mannitol","volume":"6","author":"Raillat, A.; Saint-Julien, J.; Abgrall, J.","year":"1982","unstructured":"Raillat A, Saint-Julien J, Abgrall J. Explosion colique au cours d'une electrocoagulation endoscopique apres preparations au mannitol. Gastroenterol Clin Biol 1982; 6: 301-2.","journal-title":"Gastroenterol Clin Biol"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.1016\/0016-5085(79)90172-0","article-title":"Fatal colonic explosion during colonoscopic polypectomy","volume":"77","author":"Bigard, M.A.; Gaucher, P.; Lassale, C.","year":"1979","unstructured":"Bigard MA, Gaucher P, Lassale C. Fatal colonic explosion during colonoscopic polypectomy. Gastroenterology 1979; 77: 1307-10.","journal-title":"Gastroenterology"}],"container-title":["Gut"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/gut.25.4.361","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T21:15:17Z","timestamp":1765660517000},"score":1,"resource":{"primary":{"URL":"https:\/\/gut.bmj.com\/lookup\/doi\/10.1136\/gut.25.4.361"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1984,4]]},"references-count":9,"journal-issue":{"issue":"4","published-online":{"date-parts":[[1984,4,1]]},"published-print":{"date-parts":[[1984,4]]}},"alternative-id":["10.1136\/gut.25.4.361"],"URL":"https:\/\/doi.org\/10.1136\/gut.25.4.361","relation":{},"ISSN":["0017-5749","1468-3288"],"issn-type":[{"value":"0017-5749","type":"print"},{"value":"1468-3288","type":"electronic"}],"subject":[],"published":{"date-parts":[[1984,4]]}}}