Ouer the past three decades, primary repair of colonic injuries has be
Come more accepted and there has been a trend toward using this proce
Dure for repairing civilian colonic injures. However, the best procedure re
Mains controversial forty patients with colonic injuries alone or
Associated with other organ injuries were included in the present study
Over a 44 months period benha university hospital afiei resuscitation,
Exploratory laparotomy was done and other organ injuries were appropri
Ately ^managed. Colonic mjuries were-dealt with either by primary repair,
Age? Jblood transfitsion, mechanism and site of injury and injury seventy
Indices. The mechanism of injury was stab injury in 37.5% gunshout m
• 32.5% iatrogenic in 17% and blunt trauma in 13%. Isolated colon injuries
Were found in 27.5% and associated with small intestinal injury m 47%.
The left colon injuries were found m 40% followed by transverse colon m
37.5%. Primary repair, either by debridement and simple closure m 2
Layers or by segmental resection and pnmary anastomosis was done in
65%' of patients while diversion procedures were carried out for 35% of
Patients. There were 3 mortalities (and complications occurred in 30% of
The studied patients.
From tills study we can conclude that there is no single policy for man
Agement of colon injuries either by diuersion or primary repair. Good resulis
Can be obtained by proper decision of an experienced surgeon ac
Cording to the indioidual circwnstances of each case rather than following
Solid scheme by less experienced surge primary suture should be limited
To early cases induced by sharp agents or latrogenic injury. For most se
Verely traumatized patients diversion remains the most dependable meth
Od of treatment as it is followed by the least morbidity and mortality. |
