Primary repair vs. colostomy in colon injuries.
BACKGROUND
Colon trauma is frequent and its prevalence is difficult to establish because of the different factors that intervene in its origin. In Mexico, traumatic colon injuries, albeit stab wounds or gunshot wounds, are on the rise. Our objective was to evaluate the most appropriate management for traumatic colon injuries.


METHODS
We conducted a retrospective study of 178 case files of patients with abdominal trauma and colon lesions during a 5-year period from January 2003 to June 2008 from the General Hospital of Balbuena, Mexico City. The study compared the use of primary closure vs. colostomy, analyzing variables such as sex, age, type of wound, severity of lesion and mortality.


RESULTS
There were a total of 178 patients; 156 were male (87.6%) and 22 were female (12.4%). The most affected age group was between 21 and 30 years; 74 patients (41.6%) had stab wounds and 104 patients (58.4%) had gunshot wounds. Management consisted mainly of primary closure in 92 cases (51.7%) vs. colostomy in 86 patients (48.3%). However, 64% of gunshot wounds were treated with colostomy. Reported mortality was 9.55% and this was due to different factors such as multiple organ injury.


CONCLUSIONS
Treatment of traumatic colon injury should be case specific, taking into account the mechanism of the lesion, its severity and associated injuries.
Robles-Castillo
Javier
J
Department of General Surgery, The American British Cowdray Medical Center IAP, México, D.F., Mexico. jaroca76@yahoo.com
Murillo-Zolezzi
Adrián
A
Murakami
Pablo Daniel
PD
Silva-Velasco
Jorge
J
D000007:Abdominal Injuries / Q000453:epidemiology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003106:Colon / Q000293:injuries / Q000601:surgery*; D003125:Colostomy / Q000009:adverse effects / Q000706:statistics & numerical data*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D009104:Multiple Trauma / Q000453:epidemiology / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D012189:Retrospective Studies; D012769:Shock / Q000209:etiology / Q000628:therapy; D013530:Surgical Wound Infection / Q000453:epidemiology; D013536:Suture Techniques / Q000706:statistics & numerical data; D014781:Viscera / Q000293:injuries; D014946:Wound Infection / Q000188:drug therapy / Q000453:epidemiology*; D014948:Wounds, Gunshot / Q000453:epidemiology / Q000601:surgery*; D014951:Wounds, Stab / Q000453:epidemiology / Q000601:surgery*; D055815:Young Adult