Outcome of primary repair in penentrating colonic injuries

ABSTRACT

To assess the outcome of primary repair in penetrating colonic injuries in terms of regional/local morbidity [suture line breakdown, intra-abdominal abscess] and mortality. Design: Prospective, interventional study. Place and Duration of Study Surgical Unit II at Lahore General Hospital, Lahore, over a period of 3 1/2 years from June 1999 to December 2002. Patients and Out of 38 consecutive patients with penetrating colon injuries, a selective group of 25 patients [65.7%] undergoing primary repair [simple suture, resection and anastomosis without covering colostomy and right hemicolectomy] were included in this study. The morbidity and mortality variables were recorded and statistically analyzed. Majority of our patients were of younger age group [mean 25 years]. Twenty patients [80%] were male. The commonest mode of injury was firearm injury [72%]. The time interval between injury and repair was 3-11 hours [mean 7 hours]. Simple repair of colon with interrupted stitches was the commonest procedure performed [44%], followed by right hemicolectomy [32%]. Colon related complications developed in 3 patients [12%], which included two fecal fistulae and one intra-abdominal collection. One patient died of septicemia [4%]. Hospital stay ranged between 6-16 days [mean 8 days]. Primary repair is a safe method of managing penetrating colon injuries in carefully selected patients