Is it dangerous to use an air hose to induce flatus?

Dear Cecil:

Some background. When I was a kid growing up in the late 50s-early 60s, one of the things we used to do was induce ourselves to fart by sticking the nozzle of a bicycle hand pump into our behinds and giving ourselves several pumps of air. We would then get close to another kid and open the floodgate. Although the scent wasn't potent, the sound was still funny. After we'd done this a few times, we learned to generate different kinds of sounds, ranging from a sudden burst like a sonic boom to high-pitched sound like that of an out-of-tune trumpet.

Now my question. I heard that some kids or maybe grown-ups got daring and instead of a hand pump used a compressed air hose. The sudden injection of high-pressure gas at hundreds of pounds per square inch into the intestines caused rupture and internal bleeding. I heard there were documented cases of deaths from this type of dangerous entertainment. Tell me it's not true!

Cecil replies:

What do you want to be told isn’t true? That nobody has died from injecting high-pressure air up their bums for the purpose of inducing farts? If so, you’re in luck — I couldn’t find any fart-induction fatalities in the case reports. Fact is, I couldn’t find much on recreational flatulence, period. However, if we turn to the wider question of whether a keisterful of compressed air can kill you, it sure can. The first case reported in the medical literature, in 1904, involved a 17-year-old UK male who was brought to the infirmary in pain after having “got blown up with an air force-pump.” The account isn’t very informative on how this occurred, and you probably don’t want to hear a lot of details anyway. Suffice it to say that the guy’s guts ruptured in multiple locations, spilling the intestinal contents into the abdominal cavity; peritonitis presumably set in, and three hours after admission he was dead.

That happened quite a bit in the old days. One review of 44 cases published in 1931 found that more than half the victims died. Most incidents were industrial-workplace pranks involving males fooling around with an air hose. In many, perhaps most instances the hose wasn’t forcibly inserted; on the contrary, the victim was fully clothed and the hose held to the seat of his pants or otherwise directed at him at close range, the topography of the buttocks acting as a funnel. In a few cases no prankster was involved; the fellow was just trying to blow dust off his clothes.

However it happened, the victim’s belly typically became painfully distended; after insertion of a hollow needle into the abdomen or initial incision on the operating table he deflated like a popped beach ball, providing welcome but only temporary relief if no attempt was made to repair the internal damage and stave off infection. The 1931 researcher, an MD named Burt, was sufficiently alarmed about the situation to devote a 28-page treatise to the subject, among other things establishing that the pressure required to rupture the intestine was a mere four pounds or so per square inch. The pressure generated by a compressor is many times higher, on the order of 50 to 150 PSI, and I venture to say you could push the limit with a bicycle pump.

A 1980 review totted up 93 cases of pneumatic intestinal rupture, but thereafter things seem to have quieted down. Possibly that’s because of rising maturity and intelligence in the workforce but more likely in my opinion because the industrial jobs affording access to air hoses were being exported overseas — the first Korean case was reported in 1996. The latest U.S. case I can find, as usual involving a practical joker, is from 2002; his victim, a Georgia carpentry shop employee, survived, but was out of work for three months and ran up medical bills totaling close to $70,000.

To be sure, a key difference between these folks and you is that you filled yourself up willingly whereas the prank and accident victims didn’t. Only a handful of intentional self-inflators have been reported, one of whom, interestingly, used a bicycle pump and seems to have suffered no damage, although his doctors certainly freaked. (A later account describes the fellow as mentally unbalanced; while I can understand jumping to this conclusion, the original report expresses no opinion on the man’s sanity.) I don’t mean to be alarmist — your experiments along these lines were a long time ago, and surely Xbox offers today’s youth less perilous ways to amuse themselves. Still, some things one wants to nip in the bud.

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