Management of Colonic and Rectal Injuries: A multicenter study
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2016, Vol 4, Issue 12
Abstract
Colorectal injuries are associated with septic complications in a high percentage of abdominal injuries. Proper initial management of colorectal injuries will significantly reduce septic complications and consequently mortality. The management of colorectal trauma has evolved considerably over the past several decades. The objective is to study the current surgical management of colonic and rectal injuries and to compare the morbidity and mortality of primary repair with faecal diversion. This is a prospective descriptive hospital based multicenter study conducted at Omdurman Military Hospital, El Obeid Military Hospital and Omdurman Teaching Hospital in the period from March 2014 to February 2015. Fifty two patients fulfilled the criteria for inclusion and analysis. More than half of colorectal injuries were managed with diversion. When comparing left with right-sided injuries, there was a trend toward increased stoma placement in patients with left-sided injuries (87.5% vs. 4.3%) P value 0.000. The morbidity of the right colonic injury was 26.1% and the mortality was 8.7% compared with 41.7% morbidity and 12.5% mortality in left colonic injury (P value 0.752). The complication rate for patients with colonic injury requiring a colostomy was 50% (11/22) versus 20% for the primary repair group (P value 0.382). Six out of seven patients (85.7%) with rectal injuries were managed with colostomy (P value 0.269).In conclusion; the current practice of most surgeons for management of colorectal injuries is to divert left colonic and rectal injuries and repair or resection and primary anastomosis for right colonic injuries. Patients whom were managed with colostomy were found to have higher morbidity and mortality than those managed with primary repair. Keywords:Colon injuries, rectal injuries, primary anastomosis, faecal diversion.
Authors and Affiliations
Maaz H Eisa, Aamir A Hamza
Keywords
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