ABSTRACT
The controversy regarding the management of colon injuries continues, some favouring primary repair while others lean towards a proximal defunctioning procedure. We have reported our experience in this field over a 4-year period. Forty-three patients with large bowel injuries were treated during this period and two of them died in the immediate postoperative period due to continued haemorrhage. Of the remaining 41 patients, 27 underwent primary repair of the colon and 15 per cent of them developed complications. Fourteen patients had a proximal defunctioning procedure and 50 per cent of them developed complications. When severity of injuries was taken into consideration it showed a linear relationship to complications. We conclude that primary repair of the colon should be the preferred method of treatment in patients with grade I and II injuries.
Subject(s)
Colon/injuries , Adult , Colon/surgery , Colostomy , Evaluation Studies as Topic , Female , Humans , Male , Methods , Postoperative Complications , Trauma Severity IndicesABSTRACT
From January 1985 to December 1987, 292 laparotomies were performed for injury in Riyadh Central Hospital. Of these, 15 cases were associated with diaphragmatic injuries (5.1 per cent). The diagnosis was missed in 5 cases (30 per cent) and was incidental (at laparotomy) in 3 cases (20 per cent). Therefore in about 50 per cent of the cases, the diagnosis was not made at the initial presentation. In this paper we stress the importance of maintaining a high degree of clinical suspicion in order not to miss traumatic diaphragmatic hernia in multiply injured patients.
