Primary repairing in penetrating colon injuries.
OBJECTIVE
The large bowel is injured in about 10% of penetrated abdominal injuries. Primary repair with colostomy has been discussed recently.


METHODS
Between 1987 and 1995, sixty-five patients were operated on with penetrated colon injuries were treated with primary repair without colostomy. Any patient with one or more of the following criteria was excluded: Age > 60 years, blood pressure < 80/60 mmHg, time from injury to treatment > 8 hours, Penetrating abdominal trauma index > 50.


RESULTS
The mean age of the patients was 31 and female/male ratio was 1/7. Fifty-one patients (78.5%) were exposed to colon injury by stabbing and 14 patients (21.5%) by gunshot. The most frequently injured segment was the transverse colon (36.9%). The liver was the most commonly injured organ associated with colon injury (32.3%). Colon wounds of 48 patients (73.8%) were treated with simple repair consisting of meticulous debridement. All gunshot wounds (14 patients) and 3 of the stab wounds were treated with segmentary resection and two layered anastomosis because of the massive colonic wall injury and/or impairment of the blood supply. The most common postoperative complication was wound infection (12.3%). Intraabdominal infection and leakage of the anastomosis were not observed.


CONCLUSIONS
Primary repair or, if necessary, segmentary resection and anastomosis will be more appropriate in civilian colon injuries.
Mihmanli
M
M
First Department of Surgery, Sisli Etfal Training Hospital, Istanbul, Turkey.
Erzurumlu
K
K
Güney
M
M
D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D003106:Colon / Q000293:injuries* / Q000601:surgery; D003646:Debridement; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D013530:Surgical Wound Infection / Q000453:epidemiology; D015599:Trauma Severity Indices; D014950:Wounds, Penetrating / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*