Fulminant pneumatosis coli: A rare presentation of hollow viscus injury after blunt abdominal trauma

In our case, it is likely that the minor trauma from a fall on the right side caused a small disruption of the caecal colonic mucosa (American Association for the Surgery of Trauma Grade I colonic injury) allowing air to track intramurally. Fakhry et al. demonstrated that delay to operation following blunt small bowel injury results in significantly higher mortality rates, from 2% within the first 8 h, to 30% if the delay is >24 h.[3] In our case, neither clinical nor radiological signs were present on initial assessment and ultimately the delay would have made little difference to the outcome as the patient was not fit for intervention.