A 18-year-old man was admitted with a complaint of enormous abdominal distension and gasping respiration. The patient's colon was inflated as a result of having compressed air forced through the anus by his fellow worker. Chest and abdominal X-ray and arterial blood gas analysis revealed enormous pneumoperitoneum, hypercapnia and hypoxemia (pH 7.10, PCO2 84.9mmHg, PO2 33.5mmHg). A large amount of gas (air) was released from the abdomen by puncture on the right upper quadrant, and hypercapnia was rapidly improved. Gastrografln enema revealed rupture of the transverse colon and emergency operation was performed. There was a rupture, 3cm in diameter, in the transverse colon along the tenia coli omentalis. Multiple serosal tears (16 in total) were also found throughout the remaining colon.
