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Case Reports
. 2020:66:370-373.
doi: 10.1016/j.ijscr.2019.12.035. Epub 2020 Jan 9.

Surgical management of a patient with traumatic tension pneumorachis: A rare case report

Abubaker AlAieb  1 , Saji Mathradikkal  1 , Atirek Goel  1 , Gustav Strandvik  1 , Mohammed Ellabib  1 , Syed Nabir  2 , Ahammed Mekkodathil  3 , Hassan Al-Thani  1 , Ayman El-Menyar  4
Affiliations
Case Reports

Surgical management of a patient with traumatic tension pneumorachis: A rare case report

Abubaker AlAieb et al. Int J Surg Case Rep. 2020.

Abstract

Introduction: Pneumorachis is a rare underdiagnosed phenomenon in which air enters the spinal canal mostly following injury to the respiratory system.

Presentation of case: We presented a rare case of pneumorachis associated with neurological deficits following traumatic compressed air insufflation to the rectum. A 44-year-old, male, construction laborer presented to the accident and emergency department with a history of insufflation by compressed air through his rectum, as a prank by his workmates. Imaging studies revealed pneumoperitoneum and the exploratory laparotomy showed perforation of the sigmoid colon as well as a serosal tear of the transverse colon. Resection of the sigmoid by GI staplers was done. The patient remained unwell even after surgical management and massive transfusion and eventually succumbed to his injuries on the second day in the hospital.

Conclusion: Our case suggests that pneumorachis should be considered one of the various causes for sublesional post-traumatic neurological deficits and mortality.

Keywords: Case report; Neurologic deficit; Pneumorachis; Rectal injury; Trauma.

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Conflict of interest statement

Declaration of Competing Interest None.

Figures

Fig. 1
Fig. 1
(A) Pneumoperitoneum (air under the diaphragm, blue arrow) (B) air extending to intra peritoneal and retroperitoneal region.
Fig. 2
Fig. 2
Sagittal sections of the dorsolumbar spine show free air in the spinal canal (orange arrow) and retroperitoneum (green arrow).
Fig. 3
Fig. 3
Axial images of the abdomen in soft tissue window shows free air in the spinal canal (orange arrow), intraperitoneum (blue arrow) and retroperitoneum (green arrow).
Fig. 4
Fig. 4
Axial images of the abdomen in bone window images show free air in the spinal canal (orange arrow) and retroperitoneum (green arrow).
See this image and copyright information in PMC

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