Penetrating colonic injuries: management by primary repair

ABSTRACT

To assess the out come of primary repair in Penetrating Colonic Injuries. Prospective, interventional study from August 2001 to February 2004. Setting: This study was conducted at DHQ Hospital, Bannu. All patients who sustained colonic injury either by gunshot or stab injury were included in the study. Only those patients were included who were hemodynamically stable, did not have life threatening co-existing injuries and on operation were found to have mild to moderate peritoneal fecal contamination. All patients were operated after initial resuscitation and colonic injuries found were repaired primarily without fecal diversion. During the immediate and early postoperative period, these patients were observed for any complications like peritonitis, wound infection, peri-anastomotic abscess, pelvic, sub-diaphragmatic or interloop abscesses and colocutaneous fistulae. Patients were discharged home after they passed stools and their postoperative period remained uneventful for few days. Out of the 35 patients, majority were young males [80%]. The commonest mode of injury was fire arm, seen in 80% of the cases. The time interval between injury and repair was 4-12 hours [mean 6 hours]. Simple repair with interrupted suture was the commonest procedure performed, followed by right hemicolectomy. Twelve [34%] patients developed complications in the form of wound infection, intra abdominal abscesses and fecal fistulae. The total hospital stay was 7-21 days with the mean [9 +/- 2 days]. Primary anastomosis is safe and has excellent results in Penetrating Colonic Injuries