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

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.