Evolving concepts in the management of colonic injury

Bowley, Douglas M.; Boffard, Kenneth D.; Goosen, Jacques; Bebington, Brendan; Plani, Frank

doi:10.1016/s0020-1383(00)00237-0

Cited by 22 publications

(20 citation statements)

References 25 publications

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“…28 Stab wound was 6/75 (8%) which is similar to other studies. 27 The least cause is blunt trauma which is mostly due to road traffic accident which is similar to other studies.…”

Section: Discussionsupporting

confidence: 83%

“…Mean age of (28.4 years) and 87% of patients were males, the mean age is slightly less than other studies. 27 In present study, the commonest cause of injury was shell, 35 (47%): 13 had primary repair and 35 had other mode of treatment, this figure is much high in comparison to other studies. 28 The 2 nd common cause of injury is bullet 28/75 (38%) which is low in comparison to other studies.…”

Section: Discussioncontrasting

confidence: 46%

“…32 The overall mortality was 26/75 (34.6%), this figure is somewhat high when compared with other studies. 27 Most of deaths occurred in the 1 st 24 hours 18/26 (71%) which is mainly due to injury to vital organs and the majority of them represent a challenge to surgeon to deal with it. Seventeen deaths (64.2%) were due to primary irreversible shock, 2 deaths (7%) due to associated thoracic injury.…”

Section: Discussionmentioning

confidence: 99%

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Pattern and outcomes of colonic injuries among a sample of Iraqi patients

2017

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Background: Colonic injury is one of the frequent injuries affecting different age groups especially young population. It is potentially lethal in its course and commonly associated with significant injuries to other organs. The aim of this study was to describe the pattern of presentation, management modalities and mortality of colonic injuries among a sample of Iraqi patients.Methods: This is prospective study on 75 patients who were admitted to the general surgical ward of Al-Khadimya teaching hospital, Baghdad-Iraq, with colonic injury and had surgical treatment during a period of two years. The clinical parameters included: site of colonic injuries, mode of colonic injury management shock presenting in the emergency room degree of contamination (mild, moderate, and severe), and associated intra-&extra- abdominal injuries.Results: Majority of patients were male. Mean age of sample was 28.47 years. The commonest site of injury was transverse, sigmoid, and descending colon. Primary repair was the first modality followed by repair and proximal colostomy. The overall mortality was 26/75 (35%). Eighteen deaths (71%) occurred in the first 24 hours most of them due to associated major injuries and irreversible shock. Eight deaths (29%) occurred after 24 hours all of them due to septic complications.Conclusions: Primary repair is the main approach in colonic repair. In the absence of shock, associated injuries, or gross faecal soiling, primary repair may be considered. Mortality is considered high and need to be investigated in future research.

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“…28 Stab wound was 6/75 (8%) which is similar to other studies. 27 The least cause is blunt trauma which is mostly due to road traffic accident which is similar to other studies.…”

Section: Discussionsupporting

confidence: 83%

Section: Discussioncontrasting

confidence: 46%

Section: Discussionmentioning

confidence: 99%

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Pattern and outcomes of colonic injuries among a sample of Iraqi patients

2017

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“…Blunt abdominal trauma accounts for approximately 5% to 15% of all operative abdominal injuries [3,7] . The majority of colonic injuries caused by penetrating trauma are dominant [1][2][3]5] . Nevertheless, in our experience about 6.5% of patients with blunt trauma at admission had injuries to the colon and rectum, which is slightly higher than the reported 5% [8] .…”

Section: Discussionmentioning

confidence: 99%

“…Although the colon is often injured in case of penetrating abdominal trauma, a significant proportion of colonic injuries caused by road accidents is a grossly destructive blunt type associated with damage to multiple organs [1][2][3] . The diagnosis and management of blunt colon injuries are still debatable.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and management of colonic injuries following blunt trauma

Zheng

Chen²,

Tao³

et al. 2007

WJG

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AIM:To retrospectively evaluate the preoperative diagnostic approaches and management of colonic injuries following blunt abdominal trauma. METHODS:A total of 82 patients with colonic injuries caused by blunt trauma between January 1992 and December 2005 were enrolled. Data were collected on clinical presentation, investigations, diagnostic methods, associated injuries, and operative management. Colonic injury-related mortality and abdominal complications were analyzed. RESULTS:Colonic injuries were caused mainly by motor vehicle accidents. Of the 82 patients, 58 (70.3%) had other associated injuries. Laparotomy was performed within 6 h after injury in 69 cases (84.1%), laparoscopy in 3 because of haemodynamic instability. The most commonly injured site was located in the transverse colon. The mean colon injury scale score was 2.8. The degree of faecal contamination was classified as mild in 18 (22.0%), moderate in 42 (51.2%), severe in 14 (17.1%), and unknown in 8 (9.8%) cases. Sixty-seven patients (81.7%) were treated with primary repair or resection and anastomosis. Faecal stream diversion was performed in 15 cases (18.3%). The overall mortality rate was 6.1%. The incidence of colonic injuryrelated abdominal complications was 20.7%. The only independent predictor of complications was the degree of peritoneal faecal contamination (P = 0.02). CONCLUSION:Colonic injuries following blunt trauma are especially important because of the severity and complexity of associated injuries. A thorough physical examination and a combination of tests can be used to evaluate the indications for laparotomy. One stage management at the time of initial exploration is most often used for colonic injuries.

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Colostomy and Ileostomy Care

Omana

Agarwal

2012

Geriatric Gastroenterology

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Evolving concepts in the management of colonic injury

Cited by 22 publications

References 25 publications

Pattern and outcomes of colonic injuries among a sample of Iraqi patients

Pattern and outcomes of colonic injuries among a sample of Iraqi patients

Diagnosis and management of colonic injuries following blunt trauma

Colostomy and Ileostomy Care

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