Management of Penetrating Injuries of Colon

Abstract

Objective: Types of operative measures adopted and prognosis of patients with perforating injuries to colon.

Study Design: Descriptive Study 

Place and Duration of Study: This  study was  carried  out  in    the  Surgical  Unit-I,  Nishtar  Medical College,  Multan during the period from July 2011 to December 2011.

Material and methods: All 60 patients were admitted in emergency ward with trauma to abdomen, and routine investigations were carried out.

Results: Majority of the patients i.e. 51 (85%) were injured by gunshot. Fifty five (90%) patients were male. For more extensive contamination colostomy gave complication rate 20% in grade 2 and 25% in grade-3. Patients who were anastomosed, 15% developed leakage. Out of 60 patients, 15 (25%) patients had injury at right colon, 16 (28%) had at transverse colon, 28 (46%) patients at left colon and remaining 11 (18%) patients had injury at sigmoid colon.  Out of 60 patients,  10 (16%) patients were found in injury grade–1,  44 (74%) patients in grade-2 and 6 (10%) patients in injury grade-3 were involved.  Majority of the patients i.e. 44 (74%) had more complications. There was no difference between these two groups with respect to grade of colon injury according to the colon injury severity scale or location of injury.

Conclusion:- It was observed from data that selective primary repair may be used in a significant proportion of colon wounds. It was based on classification system that employs an assessment of the extent of tissue injury, degree of fecal contamination, assessment of associated injuries; estimates of the influences of delay between injury and definitive therapy and hemorrhagic shock.