BOWEL UNDER PRESSURE: A CASE SERIES ON THE MANAGEMENT OF COLONIC BAROTRAUMA FROM INDUSTRIAL COMPRESSED AIR INTO THE ANUS IN A TERTIARY HOSPITAL IN THE PHILIPPINES marionozaeta@gmail.com

 

BOWEL UNDER PRESSURE: A CASE SERIES ON THE MANAGEMENT OF COLONIC BAROTRAUMA FROM INDUSTRIAL COMPRESSED AIR INTO THE ANUS IN A TERTIARY HOSPITAL IN THE PHILIPPINES

3

Philippines

Oral or Poster

Traumatic colonic perforations are more commonly caused by penetrating and blunt abdominal injuries however, barotrauma of the colon are rarely encountered in practice. This may arise from colonoscopy procedures, but less commonly through introduction of industrial compressed air into the colon. The extent of the injuries vary from the amount of pressure introduced and industrial devices give off extreme pressures that the colon is not accustomed to accommodate, and the management is less understood.

The mode of injury starts when high pressure air goes into the anus pushing large amounts of air into the bowels, which causes extreme dilatation and rupture of the bowels. This case series highlights two cases of bowel perforation in the transverse colon secondary to introduction of compressed air into the anus managed surgically in Batangas Medical Center.

One of which required colonic resection, and another case survived with repair of serosal tears and diversion of the perforation. Both were sent home and doing well on follow-up.

Barotrauma of the colon depends on air pressure, air flow, and accommodation of the anus and the colon. Rupture could be seen more commonly in corners of fixed areas such as the rectosigmoid junction, the descending colon and sigmoid junction, and in this study’s cases, the junction of the transverse colon and descending colon. This study aims to compare the preoperative management, intraoperative decision-making, and post-operative outcome of the surgical management of barotrauma in the colon and apply current bowel trauma guidelines and see its applicability for such injuries.