Multiple perforations of colon after compressed air injury

Multiple perforations of the colon after compressed air injury occurred. The initial perforation did not become manifest until five days after the injury. This was repaired at laparotomy and a proximal colostomy was performed. Ten days after the first operation, a second laparotomy showed a second larger tear at the level of the peritoneal reflection. After a Hartmann procedure, the patient did well and was discharged from the hospital. This case emphasizes the need for repeated exploratory surgery of the abdomen if the initial postoperative course is not uneventful since full-thickness perforation of the colon may be delayed in its presentation.