2019 Volume 39 Issue 3 Pages 541-544
A 32-year-old man was admitted to our hospital with an injury caused by a burst of compressed air in the anus. The patient complained of severe abdominal distension and pain immediately thereafter. A computed tomography scan revealed a pneumoperitoneum but did not reveal the puncture site. Percutaneous drainage via needle puncture was performed to decompress the abdomen. A laparotomy was performed, which disclosed a perforation involving the transverse colon and a wide serosal laceration of the contralateral colonic mesentery. Emphysema was noted in the mesentery from the ascending colon to the sigmoid colon. Because it was difficult to identify all damaged sites on the mesenteric side, a subtotal colectomy was performed. A temporary ileostomy was performed, and a mucous fistula was made in the remaining sigmoid colon. An ileal-sigmoid colon anastomosis was performed on the 74th day post-operatively and the ostomy was closed. In the treatment of a colon injury caused by compressed air, it is necessary to systematically explore the lower gastrointestinal tract for punctures during surgery.
