Evaluation of three methods for managing penetrating colon injuries.

Although primary intraperitoneal repair of selected penetrating colon injuries is a feasible method of treatment, injudicious use of this method, especially in wounds of the right colon, led to increased morbidity, in the group of 90 patients studied. Colostomy may be avoided in selected patients by using primary repair with exteriorization of the injured segment. The technique described is a reliable compromise which protects the patient from the danger of intraperitoneal suture line disruption and possibly avoids the inconvenience and morbidity of formal colostomy. Since exteriorized primary repair has been a safe, effective method of managing gunshot wounds of the colon in selected patients, we advocate its increased use.