Colonic Explosion During Argon Plasma Coagulation: A Systematic Review of Risk Factors, Prevention, and Management
8 affiliations
- 1Department of Internal Medicine Cooper University Hospital Camden New Jersey USA
- 2Department of Internal Medicine Dow University of Health Sciences Karachi Pakistan
- 3Cooper Medical School of Rowan University Camden New Jersey USA
- 4Department of Gastroenterology Jefferson Einstein Hospital Philadelphia Pennsylvania USA
- 5Faculty of Biology, Medicine and Health University of Manchester Manchester UK
- 6Division of Gastroenterology, Hepatology and Nutrition University of Kansas School of Medicine Kansas City Kansas USA
- 7Department of Internal Medicine University of Kansas Health System Kansas City Kansas USA
- 8Department of Gastroenterology Cooper University Hospital Camden New Jersey USA
Abstract
Introduction: Argon plasma coagulation (APC) is a non‐contact electrocoagulation technique widely used for hemostasis in gastrointestinal endoscopy. Despite its safety, rare but catastrophic complications such as colonic explosions have been reported. This systematic review aimed to synthesize available evidence on APC‐associated colonic explosions, identify risk factors, and highlight preventive and management strategies.
Methods: Following PRISMA guidelines, PubMed, Embase, Web of Science, and Cochrane CENTRAL were searched through August 2025 for studies reporting colonic explosions during APC. Eligible studies included clinical reports describing APC use in gastrointestinal procedures with outcomes of explosion or perforation. Data were extracted on patient demographics, procedural context, bowel preparation, and clinical outcomes.
Results: Ten studies, comprising 12 cases, were included. Explosions most frequently occurred during APC for radiation proctitis, adenoma, or angiodysplasia, predominantly after inadequate bowel preparation or use of enemas alone. Combustible gases—chiefly hydrogen and methane—were identified as the principal mediators. Perforation occurred in half of the cases, all of which were surgically repaired, with no reported fatalities.
Conclusion: Although rare, colonic explosion during APC remains a preventable event. Complete bowel cleansing with oral polyethylene glycol‐based agents, avoidance of air insufflation, and adherence to safety protocols are essential to minimize risk. Standardized preparation guidelines and further research are warranted.
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BibTeX
@article{hasan2026colonic,
title = {{Colonic Explosion During Argon Plasma Coagulation: A Systematic Review of Risk Factors, Prevention, and Management}},
author = {Fariha Hasan and Ayesha Liaquat and Ishan Bhalgat and Ahmer Khan and Hareesha Rishab Bharadwaj and Dushyant Singh Dahiya and Shahryar Khan and Christina Tofani and Apeksha Shah and Anthony Infantolino},
journal = {JGH open : an open access journal of gastroenterology and hepatology},
year = {2026},
month = oct,
doi = {10.1002/jgh3.70413},
url = {https://europepmc.org/article/PMC/PMC13722129},
note = {CC BY},
}
RIS
TY - JOUR
TI - Colonic Explosion During Argon Plasma Coagulation: A Systematic Review of Risk Factors, Prevention, and Management
AU - Fariha Hasan
AU - Ayesha Liaquat
AU - Ishan Bhalgat
AU - Ahmer Khan
AU - Hareesha Rishab Bharadwaj
AU - Dushyant Singh Dahiya
AU - Shahryar Khan
AU - Christina Tofani
AU - Apeksha Shah
AU - Anthony Infantolino
PY - 2026
DA - 2026/10/30
JO - JGH open : an open access journal of gastroenterology and hepatology
DO - 10.1002/jgh3.70413
UR - https://europepmc.org/article/PMC/PMC13722129
AB - Introduction: Argon plasma coagulation (APC) is a non‐contact electrocoagulation technique widely used for hemostasis in gastrointestinal endoscopy. Despite its safety, rare but catastrophic complications such as colonic explosions have been reported. This systematic review aimed to synthesize available evidence on APC‐associated colonic explosions, identify risk factors, and highlight preventive and management strategies. Methods: Following PRISMA guidelines, PubMed, Embase, Web of Science, and Cochrane CENTRAL were searched through August 2025 for studies reporting colonic explosions during APC. Eligible studies included clinical reports describing APC use in gastrointestinal procedures with outcomes of explosion or perforation. Data were extracted on patient demographics, procedural context, bowel preparation, and clinical outcomes. Results: Ten studies, comprising 12 cases, were included. Explosions most frequently occurred during APC for radiation proctitis, adenoma, or angiodysplasia, predominantly after inadequate bowel preparation or use of enemas alone. Combustible gases—chiefly hydrogen and methane—were identified as the principal mediators. Perforation occurred in half of the cases, all of which were surgically repaired, with no reported fatalities. Conclusion: Although rare, colonic explosion during APC remains a preventable event. Complete bowel cleansing with oral polyethylene glycol‐based agents, avoidance of air insufflation, and adherence to safety protocols are essential to minimize risk. Standardized preparation guidelines and further research are warranted.
SN - 2397-9070
ER -