Transanal high pressure barotrauma causing colorectal injuries: a case series (original) (raw)
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BMJ case reports, 2012
To present a case report of trans-anal barotrauma by high-pressure compressed air jet as a dangerous practical joke, that is, playful insufflation of high-pressure air jet through the anal orifice resulting in sigmoid perforation. The patient presented to emergency a day later with complaints of severe pain in the abdomen and abdominal distension following insufflation of high-pressure air jet through the anus. On examination, he had signs suggestive of perforation peritonitis and x-ray of the abdomen showed gas under the diaphragm. An emergency exploratory laparotomy was performed which revealed a 4-cm perforation in the sigmoid colon. Resection of the segment containing perforation along with the surrounding devitalised part was done with double-barrel colostomy. Reversal of colostomy was done after 8 weeks. Follow-up was uneventful.
International Journal of Surgery Case Reports, 2020
In the XIX century, the surgeon faces surgical challenges due to the creation of new technologies. Accidental or compressed air-induced injury to the colon and rectum is rare. We present the case of a 45-year-old patient who consults the emergency department, then a high-pressure rectal pneumatic trauma, with clinical findings of peritonism, managed with a Hartmann-type colostomy. and anterior resection of the rectum using laparoscopy, with findings of rectosigmoid perforation. With this, it can be demonstrated that minimally invasive surgery is a feasible approach in hemodynamically unstable patients without contraindication for pneumoperitoneum.
Pneumatic Rupture of Rectosigmoid; a Case Report
Pneumatic rectosigmoid rapture is usually occurred following the inappropriate fun by direct entering a high volume of the air through the pneumatic device to the anus. Such an event was reported for the first time in 1904 by Stone. Diagnosis and treatment of such injuries are often delayed because of some social limitations and preventing the patient form explaining the event. Colon sigmoid rupture and pneumoperitoneum is one of the most dangerous and life treating complications of entering a high volume of the air to the rectum in a short time. There are only a few reports regarding the similar cases. Here, a case of pneumatic rectosigmoid rapture was reported in a 53 year-old male following an inappropriate fun
SIGMOID COLON PERFORATION CAUSED BY COMPRESSED AIR: CASE REPORT
Indian Journal of Medical Research and Pharmaceutical Sciences , 2014
With the increasing of industrialization, usage area of high pressure air compressor became widespread. It has varied range of uses as a source of power for various tools and cleaning machines and fabrics. As a natural consequence of this, various organs and tissue injury including colorectal by using it except for the purpose has taken place in the literature. Colon injury as a result of bantering with high pressure air compressors especially among the workers around industrial fields is extremely rare but has serious morbidity and mortality rates. The case we described in this report is a case of sigmoid colon perforation in 37-year-old man who was harmed by compressed air that entered through the anus. In our opinion it is a unique cause of colonic perforation for about 150 cases of colon rupture by compressed air have been described so far. Sigmoid resection and colorectal anastamosis was performed and the patient discharged uneventfully.
A Rare Case of Colorectal Injury with Compressed Air
2014
Colorectal injures from implement on solid objects are infrequent but not rare. In the same category are injuries caused by non solid objects. Barotrauma from compressed air and liquid is less frequently encountered. In our opinion it is a unique cause of colonic injury for about 150 cases of colon rupture by compressed air have been described so far. We report a case of 51 years old male presented with the history of insertion of compressed air tube into the anus by his friends for a practical joke. The patient had severe abdominal pain with the frequent desire to defecate since the incident. On examination there was a distension involving the lower abdomen with the diffuse tenderness. His vitals were unstable. Chest x ray and x ray abdomen erect revealed pneumoperitoneum. So we did laparotomy and repair of seromuscular tear at recto sigmoid part of colon. The postoperative period was uneventful and on regular follow up. It is being presented for its rarity.
A Case of Pneumatic Rectal Perforation Caused by Compressed Air
Rectal perforation is a rare cause of acute abdomen. The most common cause of rectal perforation is trauma. Barotrauma due to the injection of compressed air in the rectum is an extremely rare cause of rectal perforation. We report a case of extensive pneumoperitoneum with abdominal compartment syndrome caused by rectal perforation secondary to the forceful injection of compressed air through the perineum. The patient was successfully managed by immediate relief of abdominal compartment syndrome by needle decompression followed by surgical repair of rectal perforation.
Fatal recto-sigmoid rupture by compressed air
Egyptian Journal of Forensic Sciences, 2016
Compressed air is a concentrated stream of air at high pressure and high speed that can cause fatal injury to the operator and the people around him when handled inappropriately. The case herein reported is that of a victim of a practical joke, who suffered a fatal recto-sigmoid rupture due to transanal insufflation of compressed air at his workplace. The case highlights the need for implementation of guidelines for safe handling of compressed gases and it also calls for appropriate work place etiquette to avoid such fatal practical jokes at work.
Pneumatic colon injury following high pressure blow gun dust cleaner spray to the perineum
International Journal of Surgery Case Reports, 2015
INTRODUCTION: A pneumatic tool or air tool such as blow gun dust cleaner is a tool driven by compressed air and spraying of the perineum can insufflate the colon due to its high pressure and high flow rate. PRESENTATION OF CASE: We present a case of 4 year old boy who developed sudden onset of tense abdominal distention and developed peritonitis. Patient's family initially denied a history of trauma. Radiologic examination showed pneumoperitoneum and colon dilatation. Exploratory laparotomy revealed a tension pneumoperitoneum, bloody ascitic fluid, multiple site of ecchymosis and serosal tear of the colon and a minute perforation of transverse colon. Postoperative reinvestigation revealed that the patient's perineum was sprayed, using blow gun dust cleaner. DISCUSSION: Air from pneumatic tools produces column of air at pressure of 3.5-8.8 kg/cm 2 and pressure greater than the resting anal pressure of 0.109 kg/cm 2 force air to enter the colon when the perineum is sprayed. Different degree of colon injury results when airflow is greater than 1.46 L/m, and/or intraluminal pressure greater than 0.109 kg/cm 2. In most children, initial anxiety to tell the truth result in difficulty to obtain good history. CONCLUSION: Spraying of the perianal with excessive pneumatic force of greater than the resting anal pressure and high air flow rate causes multiple site colon injury and tension pneumoperitoneum due to colon perforation. Parent should be caution in children playing with high pressure pneumatic tool, and the importance of history is emphases for early correct diagnosis.
Contemporary management of rectal trauma - A South African experience
Injury, 2020
Introduction: The management of rectal trauma remains controversial. There are three modalities which have been used to manage these injuries; proximal diversion (PD), washout of the distal rectum (DRW) and presacral drainage (PSD). The EAST group tentatively advocate mandatory proximal diversion for extraperitoneal rectal injuries and omitting DRW or PSD. Other authors have suggested that diversion can be eschewed in patients with an intraperitoneal injury which can be primarily repaired. In light of all these controversies, this project set out to review our experience with rectal injuries over the last seven years with the objective of reviewing our use of PD, PSD and DRW. Methods: Patients aged greater than or equal to 15 years with rectal injuries during December 2012 to July 2019 were included. Patient demographics, mechanism of injury, management strategy (operative or non-operative), complications, patient residential status (urban or rural), hospital and intensive care duration of stay, and 30-day mortality rates were assessed. Results: During the study period, a total of 51 patients with a rectal injury were treated. There were 45 (88%) males and the median age was 29 (22-39) years. There were 7 (14%) blunt mechanisms, 41 (80%) penetrating mechanisms and 3 (6%) combined blunt and penetrating mechanisms. The median ISS was 13 (9-18). Of the 50 rectal injuries ultimately treated at our institution, there were 31 extraperitoneal and 14 intraperitoneal injuries. There were five combined intra and extraperitoneal injuries. A total of 21 rigid sigmoidoscopies and a single flexible sigmoidoscopy were performed. A total of 24 patients underwent a CT scan. There were 13 primary repairs and 45 PD. A single patient required a PSD. Of the 34 documented complications, 15 (44%) were related to sepsis and can be attributed to the rectal injury. The overall mortality rate was 11.8%. Conclusions: Rectal injuries are associated with significant septic related morbidity and mortality. Although we have begun to avoid diversion in a small subset of patients with an intraperitoneal injury, we continue to perform PD for the vast majority of patients with a rectal injury. We do not perform DRW and PSD is used in highly selective cases.
Post-Traumatic Pneumoperitoneum Due to High Compression Trauma -A Case Report
Pneumoperitoneum and perforation are the most commonly seen complications in cases of rectal air entry at a high velocity in a short duration of time. We present a case of 20 year old male who was brought to emergency department with severe abdominal pain and distension for 2 hours. On asking history he told a friend of him pumped high-pressure air from an air compressor into his anus while he was working in a factory. The examination and investigations of patients were suggestive of free gas in peritoneal cavity (pneumoperitoneum) and the patient was taken for emergency exploratory laparotomy. On exploration, gaseous distention of whole colon was observed with multiple serosal tear along the colon. A defect of 2x2 cm seen in middle of transverse colon at anti mesenteric border. The defect was closed primarily.