title: Gunshot wounds of the colon. A review of 100 consecutive patients, with emphasis on complications and their causes.
abstract: The cases of one hundred civilian patients with gunshot wounds of the colon treated at the Louisville General Hospital have been reviewed. Most injuries were in the transverse colon (44%), followed by the ascending colon (27%), rectosigmoid (19%), and descending colon (10%). Associated injuries occurred in 81 per cent of the patients; the small bowel was the most common structure injured. Primary closure was used in 52% of the patients, with a resultant 19% rate of wound infection and 14% rate of serious complication. When the extent of contamination or tissue destruction required resection, an attempted primary anastomosis was followed by a high rate of wound infection (57%) and serious complications (36%) as compared with end-colostomy and mucous fistula, which resulted in a 24% rate of wound infection and 24% rate of serious complication. The rate of wound infection between these groups is significant (p = 0.05). Results end-colostomy and mucous fistula were better than with attempted primary anastomosis.
mesh_terms: D001424:Bacterial Infections / Q000209:etiology; D003082:Colectomy / Q000009:adverse effects; D003106:Colon / Q000293:injuries*; D003125:Colostomy / Q000009:adverse effects; D004926:Escherichia coli / Q000302:isolation & purification; D006801:Humans; D007081:Ileostomy / Q000009:adverse effects; D007412:Intestinal Fistula / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology; D012007:Rectum / Q000293:injuries; D013369:Subphrenic Abscess / Q000209:etiology; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D014948:Wounds, Gunshot / Q000150:complications* / Q000401:mortality / Q000601:surgery