Blunt colonic injury: a 64-case series.

BACKGROUND

Blunt colonic injuries are rare but can complicate the management of the blunt trauma patient and worsen the outcome. We analyzed in this study the colonic injuries caused by blunt abdominal trauma.

METHODS

The records of 64 patients (60 male, 4 female; mean age 39.3 years; range 16 to 69 years) were investigated retrospectively. The records were reviewed for clinical presentation, investigations, diagnostic methods, associated injuries, time from injury to operation, site of colon injury, operative management, morbidity, and mortality.

RESULTS

One-stage operation was performed in 53 cases (82.8%) and two-stage operation in 11 cases (17.2%). The treatment chosen was strongly related with the degree of fecal contamination and grade of colonic injury (p<0.01). The overall incidence of colonic injury-related abdominal complications was 26.5% (17 cases). There were six non-colon-related and one colon-related mortalities. Shock at presentation, severe fecal contamination, colon injury scale (CIS) grade, and associated injuries were related with complications and mortality.

CONCLUSION

We conclude that in patients with shock at presentation, severe fecal contamination and higher CIS grade, two-staged operation is appropriate.