Large Bowel Perforation Resulting from Barotrauma via Transanal Route by Compressed Air Jet: A Case Report

Abstract

Barotrauma-induced bowel perforation due to high-pressure air jets represents an exceptionally rare clinical entity. The authors present a case involving a 22-year-old male patient, who suffered multiple perforations of the large bowel following accidental exposure to a compressed air gun in an industrial environment. This occurrence, provoked by a co-worker’s irresponsible use of the device, emphasises the need for heightened awareness and stricter safety protocols in similar settings. Upon experiencing severe abdominal pain, the patient was promptly admitted to the hospital where an abdominal x-ray demonstrated significant pneumo-peritoneum. Emergency exploratory laparotomy confirmed extensive damage, including multiple perforations and serosal tears along the descending and sigmoid colon. Surgical management included primary repair of the perforations and the formation of a temporary ileostomy. The successful closure of the ileostomy three months later marks a crucial phase in the patient’s recovery. This case highlights the critical clinical implications of barotrauma in non-traditional settings and underscores the necessity of prompt surgical intervention, which may significantly influence patient outcomes. The novelty of this case lies in the uncommon mechanism and setting of injury, coupled with the extensive nature of the bowel damage, illustrating a rare but serious workplace hazard that necessitates greater preventive measures and awareness.

Keywords

• abdomen
• colon
• industrial
• injury
• laparotomy
• pneumoperitoneum