Our experience of emergency colorectal injury as a result of abdominal trauma

Objective: In the present study, we aimed to examine the treatments and their outcomes in cases with colon injuries after blunt and penetrating abdominal traumas. Materials and Methods: Twenty-six patients who underwent a laparotomy and were found to have a colon injury due to blunt abdominal trauma, penetrating stab injury, gunshot injury, and traffic accident were included. All patients were admitted into the emergency outpatient clinic of Gazi Yasargil Training and Research Hospital General Surgery Clinic between 2016 and 2020. The records of the cases were analyzed retrospectively. Results: Colon injuries were detected in 26 cases. All 26 (100%) cases were males with an average age of 29.80 ± 11.4 (range: 17-60) years old. Colon injuries observed during emergency operations included 18 (69.23%) patients with a GSI (gunshot injuries), 3 (11.53%) with penetrating stab injuries, 4 (15.38%) who were a part of traffic accidents and 1 (3.85%) patient with a blunt abdominal trauma. A primary colon repair was performed in 10 patients. Five patients underwent a colon resection and there were end colostomies. Four patients underwent a loop ileostomy after a colon resection and anastomosis. Colon resections with anastomoses were performed in seven patients. The mean hospitalization period was 26 ± 29.28 days. Conclusion: Patients should be classified intraoperatively with findings, such as peritoneal contamination, degree of colon injury, duration of the injury, and any accompanying injuries. (AU)

Isolated Sigmoid Colon Injury Following Blunt Trauma Abdomen - An Unusual Occurrence.

Colon injury is far more common in penetrating injury than blunt trauma. Blunt trauma to the abdomen is more likely to damage solid organs such as the liver, spleen, pancreas and kidneys. Colon injury in blunt trauma is severe and is associated with other organ injuries, making its diagnosis difficult. However, isolated sigmoid colon injury in blunt trauma is rare. We report a case of 42 year old male who presented to us with blunt trauma to abdomen following a fall on iron Jaal (Grid) with slipping of one lower limb between two iron bars. The patient presented 4 days after injury with tenderness and guarding all over abdomen. X-ray abdomen was normal, ultrasonogram of abdomen showed presence of free fluid. Patient was operated on clinical basis. A single perforation of size 2 cm×1 cm was present in proximal sigmoid colon and there was no other injury. The perforated colon loop was mobilized and brought to anterior abdominal wall as colostomy. Isolated sigmoid colon injury is rare presentation. Initial radiologic investigations and clinical presentation may be misleading.

Hollow Viscus Injury Following Blunt Abdominal Trauma: A Retrospective Study

Background: Gastrointestinal and mesenteric injuries are the third most common type of injury from blunt trauma abdomen and are associated with high rates of morbidity and mortality.Objectives: To determine the clinico-demographic profile, localization of injury, diagnostic and management methods and the outcome in cases of hollow viscus injury (HVI) following blunt trauma abdomen which were admitted to our unit. Methods: Records of patients who were admitted emergently with gastrointestinal injuries and blunt abdominal trauma between July 2014 and July 2016 were reviewed retrospectively. Results: The study group comprised 65 patients with mean age of 33.3 ± 16.2 years and a male predominance (89.2%). The commonest cause of injury was road traffic accident in 44 (67.7%) cases. Ileum was the most common site of injury detected in 31 (41.3%) followed by jejunum in 26 (34.7%) cases. Treatment comprised primary closure of perforation in 48 (64%) cases, segmental resection and anastomosis in 22 (29.3%), and stoma in 5 (6.7%) cases. Three out of 5 cases of anastomotic leak occurred in patients who were operated at 8-24 hours or beyond. Associated injury to intra-abdominal solid viscera and other sites were present in 30.7%. The mean duration of hospitalization was longer in patients with associated injuries as compared to those with isolated HVI (12.2±4.6 days versus 9.3±0.8 days). Conclusion: Early diagnosis followed by prompt surgical intervention and careful monitoring for associated injuries is the key to favourable outcome in blunt HVI.

Colorectal injury by compressed air: the rule of conservative therapy / Lesão colorretal por ar comprimido: a regra da terapia conservadora

ABSTRACT We are reporting a case of colorectal injury caused by a jet of compressed air directed from a distance towards the anus. The patient mentioned that it happened accidentally while his colleague was cleaning his clothes using compressed air. The patient presented with acute abdominal pain and distension. A contrast CT study did not show any free air or leakage. The patient was treated conservatively, progressed well and was discharged from the hospital on the fourth day.

RESUMO Descrevemos um caso de lesão colorretal causada por um jato de ar comprimido direcionado para o ânus, a certa distância. O paciente mencionou que o ocorrido foi acidental, enquanto um colega estava limpando suas roupas com ar comprimido. O paciente se apresentou com dores abdominais agudas e distensão. Um estudo de TC contrastado não demonstrou ar livre, nem vazamento. O paciente foi tratado conservadoramente, teve boa evolução e recebeu alta hospitalar no quarto dia.

A Lesson from Misdiagnosis of Colon Injury during the War / 第二军医大学学报

The incidence of misdiagnosis of colon injury is higher during the war because of limited conditions. The diagnosis of colon injury is easy to be neglected in the patients with closed wound of abdomen of penetrating wound of abdomen complicated by other trauma, the patients with complication of severe shock or craniocerebral injury causing lose of consciousness, and the colon injury patients without obvious sign of peritonitis or wound in abdomen. Complete abdominal examination with care and serious explorative laparotomy are the key to avoid misdiagnosis of colon injury. Owing to the fact that the wounded can not be observed carefully during the war, the indication of explorative laparotomy may not be so strict. The operation should be done under good light and extensive exposure. Shock must be prevented and corrected during exploration. The hepatic flexure, splenic flexure and fixing part of the colon should be examined carefully. Retropentoneal hematoma must be incised to explore if necessary. Small hematoma in the wall of colon also should be explored and managed in order to avoid delayed perforation of colon.