Ann Surg Treat Res.  2017 Jul;93(1):61-63. 10.4174/astr.2017.93.1.61.

Rectal perforation by compressed air

Affiliations
  • 1Department of Surgery, Dongguk University Ilsan Hospital, Goyang, Korea. parkyj@dumc.or.kr

Abstract

As the use of compressed air in industrial work has increased, so has the risk of associated pneumatic injury from its improper use. However, damage of large intestine caused by compressed air is uncommon. Herein a case of pneumatic rupture of the rectum is described. The patient was admitted to the Emergency Room complaining of abdominal pain and distension. His colleague triggered a compressed air nozzle over his buttock. On arrival, vital signs were stable but physical examination revealed peritoneal irritation and marked distension of the abdomen. Computed tomography showed a large volume of air in the peritoneal cavity and subcutaneous emphysema at the perineum. A rectal perforation was found at laparotomy and the Hartmann procedure was performed.

Keyword

Intestinal perforation; Rectum; Barotrauma

Figure

  • Fig. 1 Air-gun used in the work place of patient (animal feed factory).

  • Fig. 2 Extensive pneumoperitoneum. High intraperitoneal air pressure can impede venous return and induce respiratory distress.

  • Fig. 3 Free air in subcutaneous tissue of perineum, distal rectum (arrowhead), and scrotum (arrow).

  • Fig. 4 Resected segment of bowel shows rectal perforation with sharp margin.


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