Traumatic Injuries to the Colon and Rectum

ABSTRACT

The records of 70 patients who underwent curative operation for traumatized patients with either blunt or penetrating colorectal wounds, treated between january, 1987 and december, 1996 were retrospectively reviewed. A majority of the injuries were about to blunt injuries 50 cases(71.4%) from traffic accident 41 cases(58.6%), falling down 2 cases(2.9%). Injuries occured most commonly at the transverse colon and rectum in 22 case followed by sigmoid colon in 17 case. Associated intraabdominal injuries were frequent 51 cases(72.9%). Among the associated intra abdominal injury, small bowel was the most frequent site in 21 cases(30%) followed by spleen in 7 cases(10%), pancreas in 4 cases(5.7%) and major vessel in 4 case(5.7%). By operative procedure, primary closure of colon and rectum were 14 cases(20%), resection and anastomosis was 12 case(17.1%), primary closure with proximal diversion or end colostomy were 29 cases(41.4%). The complication rate was 59 case(84.2%) and the major complications were as follows wound infection 18 cases(30.5%), intraabdominal abscess 8 case(13.5%), pulmonary complication 7 cases(11.8%), enterocutaneous fistula 4 case(6.7%). Overall mortality were 11 case(15.7%) and mostly blunt and severe multiple trauma cases. The cause of death were MOF, sepsis and hypovolemia. This review covers the past 10 years acculmulation of colorectal injury management, morbidity and mortality.