Unusual blast colonic injury due to a fall

Civilian colonic injuries are usually due to penetrating injuries like gun shots, stab wounds and blunt trauma especially following road traffic accidents. Blast injuries are caused by bomb blasts, intracolonic explosion of gases after diathermy, over-enthusiastic bowel insufflation at sigmoidoscopy or by pressure hose applied to the anus. We report the case of a 28-year old man with an unusual blast injury of the colon following a fall from a colanut tree. The transverse colon was sheared off at its two ends while the descending colon was split open along its entire length. There was a delay of 14 hours before the man was discovered in the remote bush and brought to hospital. The mode of injury, its severity and the ultimate favourable outcome are quite unique considering the gross faecal soilage of the peritoneal cavity and the inevitable time lapse before the institution of medical care.