Pneumatic colon injury is a rare entity resulting from high pressure blow to perineum, Industrial accident and perineal blasting with compressed air had been commonly reported in adult and results in colon injury either with or without perforation. Spraying of the perianal with excessive pneumatic force of greater than the resting anal pressure and high air flow rate causes multiple site colon injury and tension pneumoperitoneum due to colon perforation. Air from pneumatic tools produces column of air at pressure of 3.5–8.8 kg/cm2 and pressure greater than the resting anal pressure of 0.109 kg/cm2 force air to enter the colon when the perineum is sprayed. Different degree of colon injury results when airflow is greater than 1.46 L/m, and/or intraluminal pressure greater than 0.109 kg/cm2.
