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Traditional Treatment of Colon Injuries: An Effective Method

Traditional Treatment of Colon Injuries: An Effective Method Abstract • Several recent reports have described management of penetrating colon wounds with primary closure, exteriorization, and early return to the abdominal cavity. Since this procedure was not the technique practiced at our institution, we reviewed our five-year experience with 207 patients with such wounds to determine whether a change in methods was warranted. The patients, predominantly young and male, were often victims of gunshots or stabbings. Associated injuries (intra-abdominal, 64%; extra-abdominal, 35%) were frequent. Overall mortality was 4% and included three patients who died within 24 hours of admission. Morbidity was 43%, including 17% related to colon injury. All documented colostomy closures were without mortality. We concluded that management of penetrating colon injuries by traditional methods yields low morbidity and mortality. A comparison of our results with those obtained using alternative techniques convinced us that the continued use of traditional methods in treating colon trauma is warranted. (Arch Surg 1984;119:591-594) References 1. Elkin DC: Gunshot wounds of the abdomen . Ann Surg 1943;118: 780-787.Crossref 2. Lee BJ: Wounds of the abdomen , in Weed FW, McAfee L (eds): The Medical Department of the United States Army in the World War , US Surgeon General's Office, 1927, vol 11, pp 443-469. 3. Arango A, Baxter C, Shires T: Surgical management of traumatic injuries of the right colon . Arch Surg 1979;114:703-706.Crossref 4. Ziperman HH: The management of large bowel injuries in the Korean campaign . US Armed Forces Med J 1956;7:85-91. 5. Gauchrow MI: Surgical management of traumatic injuries to the colon and rectum . Arch Surg 1970;100:515-520.Crossref 6. Okies JE, Bricher DL, Jordan GL, et al: Exteriorized primary repair of colon injuries . Am J Surg 1972;124:806-810.Crossref 7. Steele M, Blaisdell FW: Treatment of colon injuries . J Trauma 1977;17:557-562.Crossref 8. Flint LM: Intraperitoneal injuries . Heart Lung 1978;7:273-277. 9. Polk HC, in discussion, Steele M, Blaisdell FW: Treatment of colon injuries . J Trauma 1977;17:557-562.Crossref 10. Kirkpatrick JR: Management of colon injuries . Dis Colon Rectum 1974;17:319-321.Crossref 11. Flint LM: The injured colon . Ann Surg 1980;193:619-622.Crossref 12. Karanfilian R, Ghuman SS, Pathah VB, et al: Penetrating injuries to the colon . Am Surg 1982;48:103-108. 13. Stone HH, Fabian TC: Management of perforating colon trauma . Ann Surg 1979;190:430-436.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Traditional Treatment of Colon Injuries: An Effective Method

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Publisher
American Medical Association
Copyright
Copyright © 1984 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1984.01390170087017
Publisher site
See Article on Publisher Site

Abstract

Abstract • Several recent reports have described management of penetrating colon wounds with primary closure, exteriorization, and early return to the abdominal cavity. Since this procedure was not the technique practiced at our institution, we reviewed our five-year experience with 207 patients with such wounds to determine whether a change in methods was warranted. The patients, predominantly young and male, were often victims of gunshots or stabbings. Associated injuries (intra-abdominal, 64%; extra-abdominal, 35%) were frequent. Overall mortality was 4% and included three patients who died within 24 hours of admission. Morbidity was 43%, including 17% related to colon injury. All documented colostomy closures were without mortality. We concluded that management of penetrating colon injuries by traditional methods yields low morbidity and mortality. A comparison of our results with those obtained using alternative techniques convinced us that the continued use of traditional methods in treating colon trauma is warranted. (Arch Surg 1984;119:591-594) References 1. Elkin DC: Gunshot wounds of the abdomen . Ann Surg 1943;118: 780-787.Crossref 2. Lee BJ: Wounds of the abdomen , in Weed FW, McAfee L (eds): The Medical Department of the United States Army in the World War , US Surgeon General's Office, 1927, vol 11, pp 443-469. 3. Arango A, Baxter C, Shires T: Surgical management of traumatic injuries of the right colon . Arch Surg 1979;114:703-706.Crossref 4. Ziperman HH: The management of large bowel injuries in the Korean campaign . US Armed Forces Med J 1956;7:85-91. 5. Gauchrow MI: Surgical management of traumatic injuries to the colon and rectum . Arch Surg 1970;100:515-520.Crossref 6. Okies JE, Bricher DL, Jordan GL, et al: Exteriorized primary repair of colon injuries . Am J Surg 1972;124:806-810.Crossref 7. Steele M, Blaisdell FW: Treatment of colon injuries . J Trauma 1977;17:557-562.Crossref 8. Flint LM: Intraperitoneal injuries . Heart Lung 1978;7:273-277. 9. Polk HC, in discussion, Steele M, Blaisdell FW: Treatment of colon injuries . J Trauma 1977;17:557-562.Crossref 10. Kirkpatrick JR: Management of colon injuries . Dis Colon Rectum 1974;17:319-321.Crossref 11. Flint LM: The injured colon . Ann Surg 1980;193:619-622.Crossref 12. Karanfilian R, Ghuman SS, Pathah VB, et al: Penetrating injuries to the colon . Am Surg 1982;48:103-108. 13. Stone HH, Fabian TC: Management of perforating colon trauma . Ann Surg 1979;190:430-436.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: May 1, 1984

References