REVIEW JOURNAL

Nama : Wardah Fauziyah

Nim : 2210505048
Kelas : A3
KATEGORI PENJELASAN
Judul A case of transanal barotrauma by high-pressure compressed air
leading to transverse colon perforation with extensive colon serosal
tear
Nama Jurnal International Journal of Surgery Case Reports
Volume dan Volume 100 Halaman 1-3
Halaman
Bulan, Tahun Terbit November 2022
Nomor ISSN 22102612
H-Indeks 23
Penulis Takayuki Tanaka a,b,*,1, Shinichiro Ito b, Takahiro Ikeda a,b, Shun
Yamaguchi a,b, Shunsuke Kawakami a, Tomoo Kitajima a, Yusuke
Inoue b, Kengo Kanetaka b, Toru Iwata a, Susumu Eguchi b
Reviewer Wardah Fauziyah
Tanggal 2 April 2023
Abstrak Udara bertekanan digunakan untuk mengaplikasikan cat, mencuci
kendaraan atau mesin, dan menghilangkan air tetesan air setelah
mencuci instrumen presisi. Barotrauma karena udara bertekanan
tinggi sangat luar biasa jarang terjadi.
Presentasi kasus: Kami melaporkan kasus perforasi usus besar
melintang yang disebabkan oleh senapan angin bertekanan pada
seorang pria berusia 20 tahun. Dia menggunakan mesin udara
bertekanan untuk membersihkan debu setelah bekerja, dan seorang
rekan kerja memasukkan udara bertekanan secara transanal sebagai
lelucon. Meskipun dia kembali ke rumah sekali, dia berkonsultasi
dengan rumah sakit sebelumnya dengan sakit perut yang semakin
parah. Radiografi dan computed tomography (CT) menunjukkan
adanya sejumlah besar udara bebas. Pasien itu dirawat di rumah sakit
kami. Pasien menjalani operasi darurat. Perforasi usus besar
melintang dengan luas robekan serosal yang luas dan gelembung
udara yang sangat besar di dalam bursa omentum. Kolostomi laras
ganda menggunakan titik perforasi usus besar melintang untuk
dekompresi dan pengalihan stoma di ujung ileum dilakukan dengan
perbaikan robekan serosal dan drainase pembersihan perut. Empat
bulan setelah operasi, pasien menjalani kolostomi dan penutupan
stoma pengalihan. Diskusi klinis: Penatalaksanaan cedera usus besar
akibat udara bertekanan memiliki dua aspek: pneumoperitoneum
tegang dan cedera usus besar. Penanganan awal pneumoperitoneum
tegang diubah menjadi pneumoperitoneum terbuka.
 Pneumoperitoneum dan operasi darurat dini untuk cedera usus besar
direkomendasikan segera setelah ketebalan penuh perforasi
didiagnosis.

Pendahuluan Barotrauma akibat udara bertekanan tinggi sangat jarang terjadi

[1]. Sebagian besar penelitian telah melaporkan bahwa perforasi usus
besar akibat udara bertekanan terjadi pada persimpangan
rektosigmoid, kolon sigmoid, dan persimpangan sigmoid turun [2-4],
dan hanya ada sedikit penelitian tentang perforasi distal rektum
sigmoid. Secara umum, mudah untuk mendiagnosis
perforasi kolon karena distensi abdomen yang parah, nyeri, dan
tanda-tanda peritoneum, seperti kekakuan perut, nyeri tekan, dan
pantulan kelembutan, dikenali setelah terpapar udara terkompresi
[5,6], di di mana udara bebas yang sangat besar telah diamati dalam
beberapa gambar [7]. Pembedahan operasi untuk barotrauma kolon
termasuk dekompresi tabung rektal,
dekompresi intraoperatif usus dengan adanya usus yang membuncit,
reseksi segmen usus besar yang terluka parah, perbaikan perforasi
dengan kolostomi pengalihan proksimal atau enterostomi, dan
drainase dan irigasi rongga perut yang terkontaminasi [2,8,9].
Kami melaporkan kasus perforasi kolon transversal yang jarang
terjadi dengan robekan serosal usus besar yang luas yang muncul
dengan pneumoperitoneum tegang dan perforasi usus besar yang
dapat diselamatkan. Pekerjaan ini telah dilaporkan sesuai dengan
kriteria SCARE 2020 [10].
Pembahasan Seorang pria berusia 20 tahun menggunakan mesin udara bertekanan
tinggi untuk debu setelah bekerja dengan rekan kerjanya. Rekan kerja
tersebut mulai bermain-main lelucon, menempelkan udara bertekanan
ke anus pasien, dan memasukkan udara bertekanan tinggi secara
transanal sebagai lelucon.
Meskipun dia pulang ke rumah sekali, dia mengalami sakit perut
secara bertahap dan berkonsultasi dengan rumah sakit sebelumnya.
Dia menjalani radiografi dan computed tomography (CT), yang
menunjukkan adanya udara bebas yang sangat besar (Gbr. 1a dan b),
dan didiagnosis dengan perforasi. Pasien dirawat di rumah sakit kami.
Ketika tiba di rumah sakit kami, pasien berada dalam kondisi
kesadaran yang kabur dan kondisi pra-syok. Pada pemeriksaan
umum, dia dalam keadaan keadaan gangguan pernapasan dan pucat,
takikardia (126/menit) dengan takipnea (49/menit), dan tekanan darah
136/98 mmHg. Skor Glasgow Coma Scale Skor Skala Koma
Glasgow adalah E3 V3 M5. Pemeriksaan abdomen
Temuan konsisten dengan peritonitis perforasi (perut buncit).
perut, nyeri tekan, dan kekakuan). Tes laboratorium menunjukkan
jumlah sel darah putih 17.320 sel/mL, kadar CK 741 IU/ L, tingkat
LDH 271 IU/L, dan tingkat pH 7,253. Dia didiagnosis dengan
perforasi dan asidosis, dan operasi darurat dilakukan. Pada
temuan operasi, tingkat kontaminasi ringan dengan sedikit asites
 kotor dan gelembung udara besar di dalam omentum (Gbr. 2a).
Perforasi usus besar melintang dengan robekan serosal usus besar
yang luas (Gbr. 2b dan c) telah diamati. Skema temuan operasi
ditunjukkan pada Gbr. 2d. Dia menjalani kolostomi laras ganda
menggunakan kolon transversal titik perforasi untuk dekompresi dan
mengalihkan stoma di ujung ileum (Gbr. 3a) dengan perbaikan
robekan serosal dan pembersihan perut drainase. Perawatan
multidisiplin pasca operasi mungkin telah menyelamatkan
menyelamatkan nyawa pasien. Akhirnya, sekitar 4 bulan setelah
operasi awal, pasien menjalani kolostomi dan penutupan stoma
pengalihan (Gbr. 3b).
Kesimpulan Udara terkompresi bertekanan tinggi transanal dapat menyebabkan
situasi yang mematikan, dan kami mengalami hal serupa kasus yang
membutuhkan intervensi bedah
Referensi [2] R.G. Zunzunegui, A.M. Werner, T.C. Gamblin, J.L. Stephens,
D.W. Ashley,
Colorectal blowout from compressed air: case report, J. Trauma 52
(2002) 793–795.
[3] E.D. Sy, Y.I. Chiu, Y.S. Shan, R.L. Ong, Pneumatic colon injury
following high pressure blow gun dust cleaner spray to the perineum,
Int. J. Surg. Case Rep. 6C (2015) 218–221.
[4] W.B. Yin, J.L. Hu, Y. Gao, X.X. Zhang, M.S. Zhang, G.W. Liu,
et al., Rupture of sigmoid colon caused by compressed air, World J.
Gastroenterol. 22 (2016) 3062–3065.
[5] H.H. Suh, Y.J. Kim, S.K. Kim, Colorectal injury by compressed
air—a report of 2
cases, J. Korean Med. Sci. 11 (1996) 179–182.
[6] J.C. Coffey, D.C. Winter, S. Sookhai, S.P. Cusack, W.O. Kirwan,
Non-iatrogenic perforation of the colon due to acute barotrauma, Int.
J. Color. Dis. 22 (2007) 561–562.
[7] Y.J. Park, Rectal perforation by compressed air, Ann. Surg. Treat.
Res. 93 (2017) 61–63.
[8] J.Y. Choi, K.S. Park, T.W. Park, W.J. Koh, H.M. Kim, Colon
barotrauma caused by compressed air, Intest. Res. 11 (2013) 213–
216.
[9] A. Aparicio, M.C. Chamberlain, Neoplastic meningitis, Curr.
Neurol. Neurosci. Rep. 2 (2002) 225–235.
[10] T.Franchi R.A. Agha C. Sohrabi, Guideline: updating consensus
surgical CAse REport (SCARE) guidelines int, J. Surg. 84 (2020)
(2020) 226–230.
[11] J.S. Lin, M.A. Piper, L.A. Perdue, C.M. Rutter, E.M. Webber, E.
O'Connor, et al.,
Screening for colorectal cancer: updated evidence report and
systematic review for the US preventive services task force, JAMA
315 (2016) 2576–2594.
[12] S.Y. Kim, H.S. Kim, H.J. Park, Adverse events related to
colonoscopy: global trends and future challenges, World J.
 Gastroenterol. 25 (2019) 190–204.
[13] T.H. Lüning, M.E. Keemers-Gels, W.B. Barendregt, A.C. Tan,
C. Rosman,
Colonoscopic perforations: a review of 30,366 patients, Surg.
Endosc. 21 (2007) 994–997.
[14] E.W. Andrews, Pneumatic rupture of the intestine, or new type
of industrial accident, Surg. Gynecol. Obstet. 12 (1911) 63–64.
[15] C.A.V. Burt, Pneumatic rupture of the intestinal canal, Arch.
Surg. 22 (1931) 875–902.
[16] L. Bains, A. Gupta, R. Kori, V. Kumar, D. Kaur, Transanal high
pressure barotrauma causing colorectal injuries: a case series, J. Med.
Case Rep. 13 (2019) 133.
[17] S.J. Kim, S.I. Ahn, K.C. Hong, J.S. Kim, S.H. Shin, Z.H. Woo,
Pneumatic colonic rupture accompanied by tension
pneumoperitoneum, Yonsei Med. J. 41 (2001) 533–535.
[18] M. Thatte, S.V. Taralekar, K. Raghuvanshi, Colonic barotrauma
with tension pneumoperitoneum– review of literature and report of a
successfully treated case, Int. J. Sci. Res. (Ahmedabad) 3 (2014) 339–
341.
[19] M. Weber, F. Kolbus, J. Dressler, R. Lessig, Survived ileocaecal
blowout from compressed air, Int. J. Legal Med. 125 (2011) 283–287.
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Link https://doi.org/10.1016/j.ijscr.2022.107743

International Journal of Surgery Case Reports 100 (2022) 107743

Contents lists available at ScienceDirect

Case report

A case of transanal barotrauma by high-pressure compressed air leading to

transverse colon perforation with extensive colon serosal tear
Takayuki Tanaka a, b,*, 1, Shinichiro Ito b, Takahiro Ikeda a, b, Shun Yamaguchi a, b,
Shunsuke Kawakami a, Tomoo Kitajima a, Yusuke Inoue b, Kengo Kanetaka b, Toru Iwata a,
Susumu Eguchi b
a
Departmnt of Surgery, Nagasaki Rosai Hospital, Japan
b
Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan

A R T I C L E I N F O
A B S T R A C T
Keywords:
Compressed air Introduction and importance: Compressed air is used to apply paint, wash vehicles or machines, and remove water
colon perforation droplets after washing the precision instrument. Barotrauma due to high-pressure compressed air is extremely
Barotrauma rare.
Case presentation: We report a case of transverse colon perforation caused by a compressed air gun in a 20-year-
old male. He used a compressed air machine to dust after work, and a coworker inserted compressed air
transanally as a joke. Although he returned home once, he consulted a former hospital with worsening abdominal
pain. Radiography and computed tomography (CT) revealed a massive amount of free air. The patient was
admitted to our hospital. The patient underwent emergency surgery. Transverse colon perforation with extensive
serosal tears and massive air bubbles inside the omental bursa were observed. Double-barrel colostomy using
transverse colon perforation point for decompression and diverting the stoma at the ileum end was performed
with serosal tear repair and abdominal cleaning drainage. Four months after the surgery, the patient underwent
colostomy and diverting stoma closure.
Clinical discussion: The management of colon injury due to compressed air has two aspects: tension pneumo-
peritoneum and colon injury. The initial management of tension pneumoperitoneum is converted to open
pneumoperitoneum and early emergency operation for colon injury is recommended as soon as full-thickness
perforation is diagnosed.
Conclusion: Transanal high-pressure compressed air can cause lethal situations, and we encountered a similar
case that required surgical intervention.

1. Introduction
Barotrauma due to high-pressure compressed air is extremely rare
[1]. Most studies have reported that colon perforation due to com-
pressed air occurs in the rectosigmoid junction, sigmoid colon, and
sigmoid descending junction [2–4], and there have been few studies on
perforation distal to the sigmoid rectum. In general, it is easy to diagnose
colonic perforation because severe abdominal distension, pain, and
peritoneal signs, such as abdominal rigidity, tenderness, and rebound
tenderness, are recognized after exposure to compressed air [5,6], in
which massive free air has been observed in several images [7].
Surgical operations for colonic barotrauma include rectal tube
decompression,
intraoperative decompression of the bowel in the presence of a dis-
tended bowel, resection of severely injured segments of the colon,
repair of perforation with proXimal diverting colostomy or
enterostomy, and drainage and irrigation of the contaminated
abdominal cavity [2,8,9].
We report a rare case of transverse colon perforation with an
extensive colon serosal tear presenting with tension pneumoperitoneum
and salvageable colon perforation.
This work has been reported in line with the SCARE 2020 criteria
[10].

* Corresponding author at: Department of Surgery, Nagasaki Rosai Hospital, 2-12-5 Setogoshi, Sasebo, 857-0134, Nagasaki, Japan.
E-mail address: pay-it-forward.197675@hotmail.co.jp (T. Tanaka).
1
Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences 1-7-1 Sakamoto, Nagasaki, Nagasaki, Japan, 852-8501.

https://doi.org/10.1016/j.ijscr.2022.107743
Received 6 August 2022; Received in revised form 3 October 2022; Accepted 9 October 2022
Available online 13 October 2022
2210-2612/© 2022 The Authors. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. This is an open access article under the CC BY-NC-ND license
(http://creativecommons.org/licenses/by-nc-nd/4.0/).
T. Tanaka et al. International Journal of Surgery Case Reports 100 (2022) 107743

2. Case presentation revealed massive free air and distention of the colon.

A 20-year-old male used a high-pressure compressed air machine

to dust after working with his coworkers. The coworker started to play
a prank, attached the compressed air to the patient's anus, and inserted
the high-pressure compressed air transanally as a joke. Although he
returned home once, he experienced gradual abdominal pain and con-
sulted a former hospital. He underwent radiography and computed to-
mography (CT), which showed massive free air (Fig. 1a and b), and was
diagnosed with perforation. The patient was admitted to our hospital.
When he arrived at our hospital, he was in a clouded state of con-
sciousness and pre-shock state. On general examination, he was in a
state of respiratory distress and pallor, tachycardia (126/min) with
tachypnea (49/min), and a blood pressure of 136/98 mmHg. The
Glasgow Coma Scale score was E3 V3 M5. Abdominal examination
findings were consistent with perforation peritonitis (distended
abdomen, abdominal tenderness, and rigidity). Laboratory tests
revealed a white blood cell count of 17,320 cells/mL, CK level of 741
IU/ L, LDH level of 271 IU/L, and pH level of 7.253. He was diagnosed
with perforation and acidosis, and emergency surgery was performed.
On operative findings, the degree of contamination was mild with little
dirty ascites and a massive air bubble inside the omental burs (Fig. 2a).
Transverse colon perforation with extensive colon serosal tear (Fig. 2b
and c) was observed. A schema of the operative findings is shown in
Fig. 2d. He underwent double-barrel colostomy using a transverse
colon perforation point for decompression and diverting the stoma at
the ileum end (Fig. 3a) with serosal tear repair and abdominal cleaning
drainage. Postoperative multidisciplinary treatment may have saved
the patient's life. Finally, approXimately 4 months after the initial
surgery, the patient underwent colostomy and diverting stoma closure
(Fig. 3b).

3. Discussion

Barotrauma is the physical damage to body tissues caused by a dif-

ference in pressure between the gas space inside or in contact with the
body and the surrounding gas or fluid. Colonic barotrauma following
colonoscopy has been reported, with an incidence of 4 in 10,000 pro-
cedures [11–13]. However, colonic barotrauma caused by high-pressure
air compressors is rare. Colorectal perforation due to high-pressure
compressed air occurs as a result of triggering a high-pressure com-
pressed air jet against the anus or the practice of dusting clothes with
compressed air [1]. In general, a normal colon can withstand high
intraluminal pressures before rupture occurs. As the pressure
increases progressively, the serosal layer is the first to tear, followed by
the muscle and the mucosa. Andrews conducted experiments with the
intestines of
dogs and showed that perforation occurred at a pressure of 0.49–0.88
kg/cm [2,14]. Burt also showed that the average pressure required for
complete perforation of the human gastrointestinal tract is 0.29 kg/cm

a b

Fig. 1. Preoperative image findings

a: Radiography revealed massive free air in the abdominal cavity. b: CT

2
T. Tanaka et al. International Journal of Surgery Case Reports 100 (2022) 107743

a b

c d

Fig. 2. Intraoperative findings and schema

a: A massive air bubble was observed inside the omental burs. b: Perforation
observed in the transverse colon. c: Multiple extensive longitudinal colon
serosal tears are observed throughout the colon. d: Schema showing the
perforation, serosal tear, and stoma point.

Fig. 3. Physical findings after first and second operation a b

a: In the initial operation, the patient underwent double-barrel colostomy
using a transverse colon perforation point for decompression and diverting
the stoma at the ileum end. b: In the second surgery, the patient underwent
colostomy and diverting stoma closure.

[2,15]. In this case, the pressure was 0.7 MPa (7.14 kg/cm 2), and the
value was extremely above 0.29 kg/cm2.
Most reported colon injuries due to compressed air occur in the
rectosigmoid junction, sigmoid colon, and sigmoid descending
junction
[2–4], and perforations distal to the rectosigmoid junction have seldom
been reported. This may be because the rectum and anus are well sup-
ported by pelvic structures and bilateral fiXity of the rectosigmoid
junction. Thus, injury resulting from high-pressure barotrauma depends
on air pressure, airflow velocity, anal resting pressure, and distance
between the source and anus [16]. In addition, Sy et al. discussed that
during rapid air distention, the inability to produce a total obstruction
by the bending of sigmoid and high pressure allows the flow of air
proXimally to the next anatomical bending, such as splenic flexure
and hepatic flexure and ileocaecal valve, resulting in a stepwise closed
loop obstruction, causing the other site of the bowel to be injured and
perforated, and the comparison of different section of the colon shows
that the rectum supports the greatest pressure and the sigmoid, trans-
verse colon, caecum in decreasing strength [3]. While sigmoid colon
perforation has been reported in the majority of cases, this case was a
rare transverse colon perforation with an extensive colon serosal tear.
Severe abdominal distension, pain, and peritoneal signs, such as
abdominal rigidity, tenderness, and rebound tenderness, are
recognized

3
T. Tanaka et al.
as critical symptoms [5,6] Peritonitis can be easily diagnosed because
patients typically complain of abdominal pain and distension after
exposure to compressed air. In addition, radiological examinations can
reveal a distended colon or large amount of free air in the peritoneal
cavity [7]. The patient in our case also visited a former hospital with
complaints of abdominal tenderness and distention, and radiography
and CT revealed massive free air in the peritoneal cavity. Although the
patient exhibited pallor and tachypnea (respiratory rate 49/min), his
other vital signs were stable. Therefore, emergency surgery was per-
formed as soon as possible.
The management of colon injury due to compressed air has two as-
pects: tension pneumoperitoneum and colon injury [17]. Regarding
tension pneumoperitoneum, a sudden influ X of compressed air may
rarely lead to tension pneumoperitoneum. The difference between
simple pneumoperitoneum and tension pneumoperitoneum is whether
extreme tension in the abdominal space is present, which would cause
lethal hemodynamic and respiratory disorder [18,19]. The initial man-
agement of tension pneumoperitoneum is converted to open pneumo-
peritoneum. Therefore, puncturing the abdominal wall with a needle is a
simple and useful method to relieve the tension within the pneumo-
peritoneum and respiratory distress, which should be performed as
quickly as possible [1,2,17]. In this case, although respiratory distress
was present, the other vital signs were stable. In addition, the perfora-
tion was obvious on radiography and CT; therefore, it was deemed safe
to treat the patient in the operating room without puncture. Regarding
colon injury, early emergency operation is recommended as soon as full-
thickness perforation is diagnosed [1,5]. Surgical operations for colonic
barotrauma include rectal tube decompression, intraoperative decom-
pression of the bowel in the presence of a distended bowel, resection of
severely injured segments of the colon, repair of perforation with
proXimal diverting colostomy or enterostomy, and drainage and irriga-
tion of the contaminated abdominal cavity [2,8,9]. In this case, the
patient underwent double-barrel colostomy using a transverse colon
perforation point for decompression and diverting the stoma at the
ileum end with serosal tear repair and abdominal cleaning drainage.
Finally, the patient was salvageable, and closure of both stoma was
possible.
In conclusion, although colonic barotrauma due to high-pressure
compressed air may occur as a complication of recreational or
improper use, it could lead to a lethal situation. Therefore, knowing the
risks of a machine and its safe use are very important. Furthermore, if
such cases occur, it is important to treat them according to the surgical
strategy for the treatment of colonic barotrauma.
Sources of funding
We have no sponsors.
Ethical approval
This study has been exempted by our institution.
Consent
Written informed consent was obtained from the patient for publi-
cation of this case report and any accompanying images. A copy of the
written consent is available for review by the Editor-in-Chief of this
journal on request.
Registration of research studies
This paper is case report. The authors don't need to register this work.
International Journal of Surgery Case Reports 100 (2022) 107743
Guarantor
Takayuki Tanaka
Provenance and peer review
Not commissioned, externally peer-reviewed.
CRediT authorship contribution statement
TT: study design, data collection, data analysis, writing.
SI: critical revision
TI: data collection
SY: data collection
SK: data collection
TK: data collection
YI: data collection
KK: critical revision
TI: critical revision and data collection
SE: final approval of the article
Declaration of competing interest
There are no conflicts of interest.
References
[1] R.K. Brown, J.H. Dwinelle, Rupture of the colon by compressed air: report of three
cases, Ann. Surg. 115 (1942) 13–20.
[2] R.G. Zunzunegui, A.M. Werner, T.C. Gamblin, J.L. Stephens, D.W. Ashley,
Colorectal blowout from compressed air: case report, J. Trauma 52 (2002)
793–795.
[3] E.D. Sy, Y.I. Chiu, Y.S. Shan, R.L. Ong, Pneumatic colon injury following high
pressure blow gun dust cleaner spray to the perineum, Int. J. Surg. Case Rep. 6C
(2015) 218–221.
[4] W.B. Yin, J.L. Hu, Y. Gao, X.X. Zhang, M.S. Zhang, G.W. Liu, et al., Rupture of
sigmoid colon caused by compressed air, World J. Gastroenterol. 22 (2016)
3062–3065.
[5] H.H. Suh, Y.J. Kim, S.K. Kim, Colorectal injury by compressed air—a report of 2
cases, J. Korean Med. Sci. 11 (1996) 179–182.
[6] J.C. Coffey, D.C. Winter, S. Sookhai, S.P. Cusack, W.O. Kirwan, Non-iatrogenic
perforation of the colon due to acute barotrauma, Int. J. Color. Dis. 22 (2007)
561–562.
[7] Y.J. Park, Rectal perforation by compressed air, Ann. Surg. Treat. Res. 93 (2017)
61–63.
[8] J.Y. Choi, K.S. Park, T.W. Park, W.J. Koh, H.M. Kim, Colon barotrauma caused by
compressed air, Intest. Res. 11 (2013) 213–216.
[9] A. Aparicio, M.C. Chamberlain, Neoplastic meningitis, Curr. Neurol. Neurosci. Rep.
2 (2002) 225–235.
[10] T.Franchi R.A. Agha C. Sohrabi, Guideline: updating consensus surgical CAse
REport (SCARE) guidelines int, J. Surg. 84 (2020) (2020) 226–230.
[11] J.S. Lin, M.A. Piper, L.A. Perdue, C.M. Rutter, E.M. Webber, E. O'Connor, et al.,
Screening for colorectal cancer: updated evidence report and systematic review for
the US preventive services task force, JAMA 315 (2016) 2576–2594.
[12] S.Y. Kim, H.S. Kim, H.J. Park, Adverse events related to colonoscopy: global trends
and future challenges, World J. Gastroenterol. 25 (2019) 190–204.
[13] T.H. Lüning, M.E. Keemers-Gels, W.B. Barendregt, A.C. Tan, C. Rosman,
Colonoscopic perforations: a review of 30,366 patients, Surg. Endosc. 21 (2007)
994–997.
[14] E.W. Andrews, Pneumatic rupture of the intestine, or new type of industrial
accident, Surg. Gynecol. Obstet. 12 (1911) 63–64.
[15] C.A.V. Burt, Pneumatic rupture of the intestinal canal, Arch. Surg. 22 (1931)
875–902.
[16] L. Bains, A. Gupta, R. Kori, V. Kumar, D. Kaur, Transanal high pressure
barotrauma causing colorectal injuries: a case series, J. Med. Case Rep. 13 (2019)
133.
[17] S.J. Kim, S.I. Ahn, K.C. Hong, J.S. Kim, S.H. Shin, Z.H. Woo, Pneumatic colonic
rupture accompanied by tension pneumoperitoneum, Yonsei Med. J. 41 (2001)
533–535.
[18] M. Thatte, S.V. Taralekar, K. Raghuvanshi, Colonic barotrauma with tension
pneumoperitoneum– review of literature and report of a successfully treated case,
Int. J. Sci. Res. (Ahmedabad) 3 (2014) 339–341.
[19] M. Weber, F. Kolbus, J. Dressler, R. Lessig, Survived ileocaecal blowout from
compressed air, Int. J. Legal Med. 125 (2011) 283–287.