Abstract
This study was designed to determine the role of primary repair in Penetrating injuries of the colon and to evaluate the possibility of expanding use of one stage non-diversion primary repair of colon injuries, this is a prospective study of100 patients with Penetrating injuries of the colon, Primary repair was the first choice except in cases of destructive colonic damage with disseminated gross peritoneal contamination requiring colostomy; Primary repair was performed in 76% with an incidence of abdominal sepsis of 11.8%. The remaining 24% of the patients had a colostomy and the incidence of abdominal sepsis was 29.2% (P< 0.05)in our study; left-sided colonic injuries, multiple colonic perforations, shock on admission, delay >6h, more than two associated intra-abdominal injuries, moderate Flint colonic injury Severity Score (FISS) not in themselves contraindications for primary repair.
Keywords: Colon; penetrating injury; Primary repair.
References
- Curran TJ, Borzotta AP: Complications of primary repair of colon injury: literature review of 2.964 cases. Am J Surg 1999, 177:42-7.
- Stone HH, Fabian TC: Management of perforating colon trauma: randomization between primary closure and exteriorization. Ann Surg 1979, 190:430-6.
- Flint L, Vitale G, Richardson D, Polk H: The injured colon relationships and management of complications. Ann Surg 1981, 193:619-23.
- Chappuis CW, Frey DJ, Dietzen CD, Panetta TP, Buechter KJ, Cohn I Jr: Management of penetrating colon injuries: a prospective randomized trial. Ann Surg 1991, 213:492-8.
- Ivatury RR, Gaudino J, Nallathambi MN, Simon RJ, Kazigo ZJ, Stahl WM: Definitive treatment of colon injuries: a prospective study. Am Surg 1993, 59:43-9.
- Sasaki LS, Allaben RD, Golwala R, Mittal VK: Primary repair of colon injuries: a prospective randomized study. J Trauma 1994, 39:895-901.
- Gonzales RP, Palmirski ME, Holevar MR: Colostomy in penetrating colon injury: is it necessary? J Trauma 1996, 41:271-5.
- Bulger EM, Mc Mahon K, Jurkovich JG: The morbidity of penetrating colon injury. Injury, Int J Care Injuried 2003, 34:41-6.
- Bowley DM, Boffard KD, Goosen J, Bebington BD, Plani F: Evolving concepts in the management of colonic injury. Injury 2001, 32:435-9
- Faelk M, Osipov R, Foster K, Caruso D, Kassir A: The conundrum of traumatic colon injury. Am J Surg 2004, 188(6):663-70
- Demetriades D, Rabinowitz B, Sofianos C, Prumm E. The management of colon injuries by primary repair or colos- tomy. Br JI Surg 1985;72:881-3.
- Demetriades D, Lawson HH, Sofianos C, Oosthuizen M Kurstjens S, Frolich J. Healing of the right and left colon: an experimental study. S Afr MedJ 1988;73:657-8,.
- Taylor M, Logsetty S: Primary repair for penetrating colon injuries. (CAGS- Evid Based Rev Surg.12). Can J Surg 2005, 48:63-5.
Corresponding Author
Abdulbassit M. Alshallwi
Associated Professor of Surgery, Faculty of Medicine-Omar Almukhtar University
DOI: https://dx.doi.org/10.18535/jmscr/v7i9.19
