Abstract
Background: Surgical management for traumatic colonic injuries has undergone major changes in the past decades. Despite the increasing confidence in primary repair for both penetrating colonic injury (PCI) and blunt colonic injury (BCI), there are authors still advocating for a colostomy particularly for BCI. This study aims to describe the surgical management of colonic injuries in a level 1 metropolitan trauma center and compare patient outcomes between PCI and BCI. Methods: Twenty-one patients who underwent trauma laparotomy for traumatic colonic injuries between January 2011 and December 2018 were retrospectively reviewed. Results: BCI accounted for 67% and PCI for 33% of traumatic colonic injuries. The transverse colon was the most commonly injured part of the colon (43%), followed by the sigmoid colon (33%). Primary repair (52%) followed by resection-anastomosis (38%) remain the most common procedures performed regardless of the injury mechanism. Only two (10%) patients required a colostomy. There was no significant difference comparing patients who underwent primary repair, resection-anastomosis and colostomy formation in terms of complication rates (55% vs. 50% vs. 50%, p = 0.979) and length of hospital stay (21 vs. 21 vs. 19 days, p = 0.991). Conclusions: Regardless of the injury mechanism, either primary repair or resection and anastomosis is a safe method in the management of the majority of traumatic colonic injuries.
Highlights
Major abdominal trauma is commonly encountered as a polytrauma, resulting in imminently life-threatening condition
This study describe the surgical management of for traumatic colonic injuries in our 15 aims years to and older who underwent laparotomy the management of traumatic institution and to compare patient outcomes between colonic injury between the 1 January 2011 and 31 December 2018 were included in this study
There was no significant difference comparing patients who underwent primary repair, resection-anastomosis and colostomy formation in terms of complication rates
Summary
Major abdominal trauma is commonly encountered as a polytrauma, resulting in imminently life-threatening condition. Blunt colonic injuries (BCIs) can be very destructive (Figure 1), and are associated with multiple organ damage causing significant clinical compromise [1]. Despite the increasing confidence in primary repair for both penetrating colonic injury (PCI) and blunt colonic injury (BCI), there are authors still advocating for a colostomy for BCI. This study aims to describe the surgical management of colonic injuries in a level 1 metropolitan trauma center and compare patient outcomes between PCI and BCI. Methods: Twenty-one patients who underwent trauma laparotomy for traumatic colonic injuries between. There was no significant difference comparing patients who underwent primary repair, resection-anastomosis and colostomy formation in terms of complication rates (55% vs 50% vs 50%, p = 0.979) and length of hospital stay
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