Robles-Castillo Javier, Murillo-Zolezzi Adrián, Murakami Pablo Daniel, Silva-Velasco Jorge
Department of General Surgery, The American British Cowdray Medical Center IAP, México, D.F., Mexico.
Cir Cir. 2009 Sep-Oct;77(5):365-8.
Colon trauma is frequent and its prevalence is difficult to establish because of the different factors that intervene in its origin. In Mexico, traumatic colon injuries, albeit stab wounds or gunshot wounds, are on the rise. Our objective was to evaluate the most appropriate management for traumatic colon injuries.
We conducted a retrospective study of 178 case files of patients with abdominal trauma and colon lesions during a 5-year period from January 2003 to June 2008 from the General Hospital of Balbuena, Mexico City. The study compared the use of primary closure vs. colostomy, analyzing variables such as sex, age, type of wound, severity of lesion and mortality.
There were a total of 178 patients; 156 were male (87.6%) and 22 were female (12.4%). The most affected age group was between 21 and 30 years; 74 patients (41.6%) had stab wounds and 104 patients (58.4%) had gunshot wounds. Management consisted mainly of primary closure in 92 cases (51.7%) vs. colostomy in 86 patients (48.3%). However, 64% of gunshot wounds were treated with colostomy. Reported mortality was 9.55% and this was due to different factors such as multiple organ injury.
Treatment of traumatic colon injury should be case specific, taking into account the mechanism of the lesion, its severity and associated injuries.
结肠创伤很常见，由于其发病涉及多种不同因素，其患病率难以确定。在墨西哥，创伤性结肠损伤，无论是刺伤还是枪伤，都在增加。我们的目的是评估创伤性结肠损伤最恰当的处理方法。
我们对墨西哥城巴尔维纳综合医院2003年1月至2008年6月这5年期间178例腹部创伤且有结肠损伤患者的病历进行了回顾性研究。该研究比较了一期缝合与结肠造口术的使用情况，分析了性别、年龄、伤口类型、损伤严重程度和死亡率等变量。
共有178例患者；156例为男性（87.6%），22例为女性（12.4%）。受影响最大的年龄组为21至30岁；74例患者（41.6%）有刺伤，104例患者（58.4%）有枪伤。处理方法主要包括92例（51.7%）一期缝合和86例（48.3%）结肠造口术。然而，64%的枪伤患者接受了结肠造口术治疗。报告的死亡率为9.55%，这是由多器官损伤等不同因素导致的。
创伤性结肠损伤的治疗应根据具体情况而定，要考虑损伤机制、严重程度及相关损伤情况。
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