Surgery

Biography

Biography: Unnati M Shah

Abstract

Pneumatic colon injury is a rare entity resulting from high pressure blow to perineum, industrial accident and perineal blasting with compressed air had been commonly reported in adult and results in colon injury either with or without perforation. 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. Air from pneumatic tools produces column of air at pressure of 3.5-8.8 kg/cm² and pressure greater than the resting anal pressure of 0.109 kg/cm² 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/cm². We are presenting a rare case of 26-year-old male who developed sudden onset of tense abdominal distention followed by peritonitis. History revealed that the patient’s perineum was sprayed, using high pressure industrial device. Patient came to emergency department and was managed as per protocol of acute abdomen. X-ray abdomen showed air under diaphragm, so patient was taken for emergency exploratory laparotomy revealed a tension pneumoperitoneum, multiple site of ecchymosis and serosal tear of the colon and perforation of sigmoid colon. Primary closure of perforation with omentopexy followed by temporary loop colostomy was done. Postoperatively patient was shifted to ward and IV antibiotics were given. Patients with acute abdominal pain of unknown origin should be checked for history of trauma and occupational history using compressed air.