A case of explosion injury due to boiler accident

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  • Ishizawa Yoshiya
    Emergency and Critical Care Center, Aomori Prefectural Central Hospital

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  • ボイラー事故による爆傷の1例

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Abstract

The patient, a 39-year-old male, was found pinned between an exterior wall and a pillar after the boiler exploded while he was changing. He sustained second-degree burns on the face, both upper extremities, and in the airway. He had an open fracture of the left lower leg and a fracture of the right lower leg. He was transported to our hospital by a medical helicopter from the nearest hospital. Upon arrival at our hospital, his blood pressure was 93/62 mmHg, pulse was 120 beats per minute, and the FAST examination was positive. He was admitted after undergoing emergency laparotomy on the same day for damage control, repair of a mesenteric injury and perforation of the ileum, vacuum pack closure, and external fixation of the left lower leg. He underwent gastrointestinal reconstruction and laparotomy closure 48 hours later. The patient's surgical course seemed to be good, but it took 3 weeks for improvement due to prolonged intestinal paralysis. It is possible that systemic inflammation caused by the shock of the explosion might have prolonged intestinal paralysis. Abdominal trauma caused by an explosion might require more careful evaluation before resumption of enteral nutrition than usual cases of acute abdomen or abdominal trauma.

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