Sağıroğlu Tamer, Tunca Fatih, Eren Eryiğit, Meydan Burhan, Gezer Cem, Tunca Erhan
Dr. Lütfi Kırdar Kartal Education and Investigation Hospital, General Surgery Department, İstanbul, Turkey.
Istanbul University, Faculty of Medicine, Department of General Surgery, İstanbul, Turkey.
Eurasian J Med. 2008 Apr;40(1):29-32.
When considering abdominal region injuries, the colon is one of the most frequently wounded organs. Due to the septic contents of the colon, failure to treat or improper treatment of colon injuries increases the risk of major complications and may result in death. The aim of our study is a retrospective evaluation of colon injury cases over a 5-year period.
Forty-nine patients with a diagnosis of colon injury were included in the study. The cause of colon injury, injured area, Flint colon injury score, additional organs injured, type of surgical procedure performed, postoperative complications and mortality were evaluated.
The most frequent cause of colon injury was cutters (57.2%), followed by firearms (36.7%). The left colon was the most common site of injury (40.8%), followed by the transverse (28.6%) and right colon (20.4%). Primary treatment or resection and primary anastomosis were performed on 38 patients (77.6%), while primary treatment and proximal decompression colostomy were performed on 11 patients (22.4%). Eighteen of the patients (36.7%) experienced major postoperative complications, and 6 patients (12.2%) died.
The morbidity and mortality of colonic injuries can be reduced by rapid patient transportation, good operational experience, use of wide spectrum antibiotics and postoperative care in an intensive care unit.
在考虑腹部区域损伤时,结肠是最常受伤的器官之一。由于结肠内含有感染性物质,结肠损伤若未得到治疗或治疗不当会增加严重并发症的风险,甚至可能导致死亡。我们研究的目的是对5年期间的结肠损伤病例进行回顾性评估。
本研究纳入了49例诊断为结肠损伤的患者。对结肠损伤的原因、损伤部位、弗林特结肠损伤评分、其他受伤器官、所实施的手术方式、术后并发症及死亡率进行了评估。
结肠损伤最常见的原因是刀具伤(57.2%),其次是火器伤(36.7%)。左半结肠是最常见的损伤部位(40.8%),其次是横结肠(28.6%)和右半结肠(20.4%)。38例患者(77.6%)接受了一期治疗或切除并一期吻合术,11例患者(22.4%)接受了一期治疗和近端减压结肠造口术。18例患者(36.7%)出现了严重的术后并发症,6例患者(12.2%)死亡。
通过快速转运患者、丰富的手术经验、使用广谱抗生素以及在重症监护病房进行术后护理,可以降低结肠损伤的发病率和死亡率。