Ethnic differences in birth statistics from central Birmingham.

this accident. Experiments have shown, however, that halothane of less than 7% concentration in 70% nitrous oxide with 30% oxygen cannot be ignited by a power source of 80-120 J, which is much greater than that used in surgical diathermy (10 J).' The presence of other gases, such as hydrogen and methane, would make an explosion possible. We postulate that fermentation can occur in an obstructed stomach and produce explosive mixtures. We report this case to make surgeons aware that explosive gases may accumulate in the stomach when the gastric outlet is obstructed. Before operation we were unaware of the extent of the obstruction in this patient. We recommend that an obstructed stomach be completely emptied through a wide bore nasogastric tube either before or during surgery before cutting diathermy is used for gastrotomy. Alternatively, cutting diathermy could be avoided when the gastric outlet is obstructed.