Pneumatic colonic rupture accompanied by tension pneumoperitoneum

Rupture of the colon caused by high pressure compressed air is a rare, uniq ue and traumatic intra-abdominal injury. As the use of compressed air in in dustrial work has increased, so has che risk of associated pneumatic injuri es from its improper use. Recently we experienced a case of pneumatic ruptu re of the sigmoid colon accompanied by tension pneumoperitoneum, which caus ed respiratory distress. The patient's respiration was very rapid with the rate of 44 breaths per minute. On arterial blood gas analysis, pH was 7.40, pO(2) 68 mmHg, pCO(2) 44 mmHg, and SaO(2) 90%. Chest X-ray film showed mar ked pneumoperitoneum and an elevated diaphragm. The respiratory distress wa s severe and required immediate relief by emergency decompression peritoneo centesis before surgical intervention consisting of the serosal rear repair , colonic rupture colostomy and abdominal cavity irrigation. A follow up op eration 2 months later for colostomy repair completed the patient's recover y.