A Case of Emphysema which Spread through the Mediastinum from an Anorectal Injury Caused by a Personal Watercraft Accident

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  • Shinozaki Yukari
    Department of gastroenterological surgery, SAGA PREFECTURAL HOSPITAL KOSEIKAN
  • Sumi Kenji
    Department of gastroenterological surgery, SAGA PREFECTURAL HOSPITAL KOSEIKAN
  • Yamaji Kotarou
    Department of gastroenterological surgery, SAGA PREFECTURAL HOSPITAL KOSEIKAN
  • Tanaka Toshiya
    Department of gastroenterological surgery, SAGA PREFECTURAL HOSPITAL KOSEIKAN
  • Sato Seiji
    Department of gastroenterological surgery, SAGA PREFECTURAL HOSPITAL KOSEIKAN

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  • 水上バイクからの落水による外傷性直腸損傷から縦隔にまで広がる気腫にいたった1例

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We report herein on a case of anorectal injury with emphysema from the anal area to the mediastinum caused by a personal water craft accident. A 20-year-old female riding on the back seat of a craft fell into the water and complained of perianal pain. Physical examination showed anorectal tears at the posterior side. Computed tomography revealed emphysema spreading from the anal area to the mediastinum. We diagnosed anorectal injury and severe emphysema caused by the water jet propulsion system and performed an emergency operation. Suturing of the injured organs, a transverse colostomy and drainage of the retroperitoneal space were performed. The patient was discharged from the hospital 22 days after the surgery. However, she still needed self-catheterization. Nowadays, severe traumatic injuries caused by personal water craft are increasing and the public have been alerted by the Japan Transport Safety Board to pay more attention to prevent and handle such accidents. In our reported case, the symptoms were not serious at the first visit, however, injuries can be much more severe, with some associated adverse side effects. More safety education by the government might be needed to prevent similar accidents.

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