Penetrating Colon Trauma

Abstract

Of 56 patients with penetrating colon injuries over 6 wk, 15% underwent exteriorized repair, 21% received a colostomy and 64% were treated with primary repair. Of the 8 exteriorized repairs, 4 required conversion to colostomies. In the entire group of 12 colostomies, there were 2 deaths, 4 abscesses, and 1 empyema. Thirty-six patients (64%) underwent primary repair. In this group there was 1 superficial wound infection, 1 empyema, but no intra-abdominal abscesses. Eighty percent had associated injuries. All laparotomy incisions in the primary repair group except 2 were closed primarily. Large amounts of saline irrigant were used in all cases. All patients receive broad spectrum antibiotics pre- and postoperatively. Primary repair of colon injuries can be done safely in many cases. Proper attention must be given to the associated injuries, the patient''s general condition, and the time interval between injury and repair. Few indications for exteriorization of injured colons were found. Colostomies are done if the criteria for safe primary repair are not fulfilled.