Sewer Gas Explosion In A Public Lavatory: An Unheard Cause Of Genital Burns

摘要

Introduction:Sewer gas explosion emanating from the toilet seat fitting in a civilian public lavatory is unheard of. It can cause death by respiratory failure due to intoxicating gases as well as morbid physical injuries by way of burns, more so in the genital region.Case report:A case of genital burns caused by a sewer gas explosion emanating from the toilet seat is reported.Discussion:The mechanism of explosion, morbidity and management of genital burn injures is discussed along with a brief review of literature.Conclusion:Prompt assessment of systemic toxicity as well as local injuries followed by meticulous treatment is pivotal in keeping the morbidity and mortality to a bare minimum. Introduction Genital burns are rare injuries. Several agents such as flames, hot liquids and chemical agents are responsible for causing genital burns. Electrical burn injuries have also been described. Patients’ age and their environment have been found to have a definite impact on the etiology. Sewer gas explosion occurring in a public lavatory is extremely rare. Genital burns caused by such an explosion while in the lavatory are unheard of. A case of genital burns caused by sewer gas explosion in the lavatory is presented along with a brief review of the mechanism of the explosion and management of genital burns. Case Report A 22-year-old male patient presented to the casualty department with history of burn injuries to the scrotum, penis, inner sides of both thighs adjacent to the scrotum and the perianal region following an explosion emanating from the toilet seat in a public lavatory. The patient did not give any history of lighting or smoking a cigarette while in the lavatory. On physical examination, the vital parameters were within normal limits. Systemic examination with special emphasis on the neurological and respiratory systems did not reveal any abnormal findings. Local examination revealed second degree burns involving the skin of the penis, anterior aspect of the scrotum, the inner sides of both thighs adjacent to the scrotum and the perineum (Figure1). The patient was admitted to the hospital. Intravenous analgesics, fluids and antibiotics were administered immediately. A combination of ceftriaxone, amikacin and metronidazole was given in view of the proximity of the burn injuries to the anal opening. Wound care was administered by application of topical antimicrobial agents. Urinary catherisation was not done as the patient was passing urine without any difficulty. The patient was kept in hospital for a period of four days and discharged thereafter. He has been following up and has shown complete recovery with no residual morbidity with respect to the penis and the scrotum.