Abdominal injuries in the war wounded of Afghanistan: a report from the International Committee of the Red Cross Hospital in Kabul.

This report is from the hospital opened by the International Committee of the Red Cross, in Kabul, which receives acute war-wounded patients from the Afghanistan conflict. Of more than 1000 operations carried out by the New Zealand team in a 6-month period, there were 70 laparotomies for penetrating wounds. These injuries were dealt with by established surgical techniques. The main area of controversy was the management of colonic wounds where the recent trend away from mandatory colostomy was followed by good results. Selective primary repair was achieved in 16 of 27 patients with colonic injury with no mortality and minimal morbidity. The right colon was considered particularly favourable for primary anastomosis. The overall mortality rate for all laparotomies was 13 per cent, with injuries to the liver, major veins and rectum particularly being fatal. There were eight negative laparotomies.