Case Report
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 14, 2016; 22(10): 3062-3065
Published online Mar 14, 2016. doi: 10.3748/wjg.v22.i10.3062
Rupture of sigmoid colon caused by compressed air
Wan-Bin Yin, Ji-Lin Hu, Yuan Gao, Xian-Xiang Zhang, Mao-Shen Zhang, Guang-Wei Liu, Xue-Feng Zheng, Yun Lu
Wan-Bin Yin, Ji-Lin Hu, Yuan Gao, Xian-Xiang Zhang, Mao-Shen Zhang, Guang-Wei Liu, Xue-Feng Zheng, Yun Lu, Department of General Surgery, Affiliated Hospital of Qingdao University, Qingdao 266500, Shandong Province, China
Author contributions: Yin WB designed the research; Lu Y critically revised the manuscript; and all authors contributed to the preparation of the manuscript and have read and approved the final version to be published.
Institutional review board statement: The study was reviewed and approved by the Affiliated Hospital of Qingdao University Institutional Review Board.
Informed consent statement: All study participants or their legal guardian provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yun Lu, MD, Department of General Surgery, Affiliated Hospital of Qingdao University, No. 1677 Wutaishan Road, Huangdao District, Qingdao 266500, Shandong Province, China. cloudylucn@126.com
Telephone: +86-532-82919520 Fax: +86-532-82911999
Received: November 8, 2015
Peer-review started: November 9, 2015
First decision: November 27, 2015
Revised: December 11, 2015
Accepted: December 30, 2015
Article in press: December 30, 2015
Published online: March 14, 2016
Processing time: 116 Days and 20.3 Hours
Abstract

Compressed air has been generally used since the beginning of the 20th century for various applications. However, rupture of the colon caused by compressed air is uncommon. We report a case of pneumatic rupture of the sigmoid colon. The patient was admitted to the emergency room complaining of abdominal pain and distention. His colleague triggered a compressed air nozzle against his anus as a practical joke 2 h previously. On arrival, his pulse rate was 126 beats/min, respiratory rate was 42 breaths/min and blood pressure was 86/54 mmHg. Physical examination revealed peritoneal irritation and the abdomen was markedly distended. Computed tomography of the abdomen showed a large volume of air in the abdominal cavity. Peritoneocentesis was performed to relieve the tension pneumoperitoneum. Emergency laparotomy was done after controlling shock. Laparotomy revealed a 2-cm perforation in the sigmoid colon. The perforation was sutured and temporary ileostomy was performed as well as thorough drainage and irrigation of the abdominopelvic cavity. Reversal of ileostomy was performed successfully after 3 mo. Follow-up was uneventful. We also present a brief literature review.

Keywords: Colon; Rectum; Colon rupture; Intestinal perforation; Compressed air

Core tip: Rupture of the sigmoid colon caused by compressed air is uncommon. Most of the injuries occur around the junction of the rectum and sigmoid colon. Abdominal distention and pain develop abruptly, and if colon perforation also occurs, symptoms of peritoneal irritation are also present. The diagnosis is not difficult if the patient has a history of abdominal pain and distention after exposure to compressed air. The management of pneumatic colon injury has two aspects: tension pneumoperitoneum and colon injury. Moreover, in our opinion, prevention and treatment of shock is essential. The prognosis has been favorable in recent years.