Operating Team
Dr. Srihari R. Shapur
MBBS, MS, DipMAS, EGIAGES
Dr. Srivachan S. Shapur
MBBS, MS, FSGE
A Workplace Incident with Serious Consequences
A 22-year-old gentleman presented to the Emergency Department with severe abdominal pain and repeated vomiting following accidental exposure to high-pressure compressed air through the rectum at his workplace.
Although uncommon, compressed air can generate pressures high enough to rupture the bowel, resulting in generalized peritonitis and the need for emergency surgery.
Early Diagnosis Saves Lives
Clinical examination revealed features of an acute abdomen.
An erect abdominal X-ray demonstrated free air beneath the diaphragm (pneumoperitoneum). Contrast-enhanced CT abdomen confirmed free intraperitoneal air with findings suggestive of bowel perforation, prompting emergency exploratory laparotomy.
Case Presentation Video
Operative Findings
Emergency exploratory laparotomy revealed:
- Approximately 300 mL of purulent contamination with fibrinous flakes
- 1 × 1 cm cecal perforation
- Dilated small bowel loops
- Incidentally detected Meckel’s diverticulum
Surgical Management
The patient underwent:
- Emergency exploratory laparotomy
- Primary closure of the cecal perforation
- Reinforcement with an omental patch
- Wedge excision of incidental Meckel’s diverticulum
- Thorough peritoneal lavage
- Protective loop ileostomy
Why This Case Is Unique
Compressed-air injuries to the bowel are rare but potentially life-threatening. While the rectum and sigmoid colon are the most commonly affected sites, this patient sustained an isolated cecal perforation, making it an uncommon and educational presentation.
Prompt diagnosis and timely surgical intervention resulted in a successful outcome.
Compressed Air Is Not a Toy
Industrial compressed air should never be directed towards any part of the body, even as a prank. Such injuries can rapidly lead to bowel perforation, severe infection, emergency surgery, and may become life-threatening if treatment is delayed.