Rectal Perforation by High Pressure Compressed Air, A Case Report

Background:Rectal trauma is rare. Mostly affecting males (> 85%). Its location (intra vs extra-peritoneal) determines its management. Rectal injuries cause peritonitis, sepsis and even death if not detected early. Associated mortality is 3% whereas morbidity is 25%.Case Study:We report a 11 year old male presented with generalized abdominal pain after inserting a high pressure compressor in his anus. His past medical history wasn t significant. On physical examination he was alert oriented and febrile (38.2°C). Chest wall and abdominal wall have generalized emphysema and abdominal tenderness rebound tenderness especially in lower abdomen was seen. Laboratoryfindings revealed mild leukocytosis. Chest X-ray showed air under the diaphragm bilaterally.Explorative laparotomy revealed a clean abdominal cavity, with no spillage or contamination.Preliminary bowel examination showed no clear perforation. Retro peritoneal from pelvic to diaphragm and large bowel wall have generalize emphysema. Peri anal laceration was seen (9 o clock) so colostomy in sigmoid was done. No complications after one month follow-up.Discussion:Colo-rectal barotraumas by compressed air may cause rectal perforation. Mostly at the antimesenteric surface of the sigmoid colon. Plain radiographs aid diagnosis. Computed tomography (CT) is sensitive and specific for rectal injury. The gold standard treatment of intra-peritoneal perforations is primary repair.Conclusion:Rectal perforation by compressed air is uncommon. Primary repair is appropriate in early presentations, minimal tissue damage and no peritoneal contamination.

کلیدواژه ها:

Rectum ، Barotraumas ، Colon ، Perforation ، Compressed air