BackgroundIn our study, we have defined and evaluated risk factors for the development of post‐operative complications in patients with gunshot wounds to the colon. The purpose of the study is to identify the most influential risk factors.MethodsA retrospective study of 172 patients admitted with gunshot wounds to the colon from 17 February 2011 to 31 December 2014. Age, gender, shock upon admission defined by vital signs and haemoglobin level, blood transfusion, injured site of the colon, the colon injury score, faecal contamination, surgical procedure, colon diversion, multiple organ injuries, delay time pre‐operation and duration of the operation were considered as risk factors. All patients were observed for any postoperative complications.ResultsOne hundred and sixty‐six patients (96.5%) were males, and six (3.5%) were female. The mean age was 28.5 years. On admission 104 (60.5%) patients were in shock, 89 (51.7%) required blood transfusion. Forty‐four (25.5%) patients had an injury to the ascending colon, while 53 (30.8%), 13 (7.6%), 23 (13.4%), 21 (12.2%) and 18 (10.5%) patients had an injury in transverse, descending, sigmoid, rectum and multiple colon injuries respectively. A colon diversion was used in 64 patients (37.2%). Post‐operative complications documented in 67 (38.9%) patients, 35 (20.3%) required re‐exploratory laparotomy, while the disability occurred in 18 (10.4%)) cases, and post‐operative mortality was 12 (6.9%).ConclusionSurgeons should be aware that shock state upon admission and blood transfusion are risk factors for postoperative complications in a patient with a gunshot penetrating injury to the colon.

Non-invasive hepatobiliary cystadenomas present as large central/left-sided cysts in young or middle-aged women. Associated malignancy was relatively uncommon and found within mural nodules. Intra-operative frozen section analysis was ineffective at ruling out cystadenomas. Complete excision is recommended, but close follow-up might be considered in patients with a prohibitive technical or medical risk, in the absence of nodularity on high-quality imaging.