https://doi.org/10.4081/crest.2024.27

Beyond breathless: a case of air infiltrating every cavity

Vol. 2 No. 1 (2024)
Submitted: February 20, 2024
Accepted: August 7, 2024
Published: September 16, 2024
Perineal injury, pneumoperitoneum, pneumothoracies, scuba, high-pressure injury
Abstract Views: 1357
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Authors

Hawaii attracts 10 million tourists annually, with non-residents accounting for 9% of trauma cases, half of which are water-related. We experienced a SCUBA tank injury, causing extensive trauma from pressurized air release. A 53-year-old female, post-Scuba diving, fell onto a SCUBA tank, causing rapid pressurized air discharge. She presented with perineal pain, bloating, and extensive subcutaneous emphysema. CT revealed air in every possible cavity. Thoracostomies and exploratory laparotomy performed, revealing an 80-90% anal sphincter transection. An overlapping anal sphincteroplasty with diverting loop ileostomy was performed. Recovery was uncomplicated. This unique case involves a traumatic SCUBA tank air release causing extensive damage. The patient avoided direct anorectal entry, preventing catastrophic damage but sustained an anal sphincter complex injury. Air likely entered the peritoneum through the levator ani, causing pneumoperitoneum and pneumothoracies. The extensive damage emphasizes the need for safe water sports practices. The patient’s recovery highlights the human body’s resilience in unique situations.

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Crossref
Scopus
Google Scholar
Europe PMC
Hawai’i State Department of Health, Emergency Medical Services Injury Prevention System Branch, Injury Prevention and Control Section. Injuries in Hawaii 2007 - 2011. Available from: https://health.hawaii.gov/injuryprevention/files/2013/10/Databook-FINAL-Sept-20121.pdf
Newman RK, Dayal N, Dominique E. Abdominal compartment syndrome. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.
David A. Score et al. The National Oceanic and Atmospheric Administration (NOAA) Diving Manual. Office of Marine and Aviation Operations. Apr 5, 2017.
Sy ED, Chiu YI, Shan YS, Ong RL. Pneumatic colon injury following high pressure blow gun dust cleaner spray to the perineum. Int J Surg Case Rep 2015;6C:218-21. DOI: https://doi.org/10.1016/j.ijscr.2014.12.022
Woltjen JA. A retrospective analysis of cecal barotrauma caused by colonoscope air flow and pressure. Gastrointest Endosc 2005;61:37–45. DOI: https://doi.org/10.1016/S0016-5107(04)02453-8
Burt CAV. Pneumatic rupture of the intestinal canal. Arch Surg 1931;22:875–902. DOI: https://doi.org/10.1001/archsurg.1931.01160060003001
Rosenberg IL, Smiddy FG. Insufflation injury of the bowel. Arch Surg 1972;105:113-5. DOI: https://doi.org/10.1001/archsurg.1972.04180070111024

How to Cite

Tsuruta, M., Goto, D., & Furuta, S. (2024). Beyond breathless: a case of air infiltrating every cavity. Case Reports in Emergency Surgery and Trauma, 2(1). https://doi.org/10.4081/crest.2024.27
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