Gunshot wounds of the colon. A review of 100 consecutive patients, with emphasis on complications and their causes.

The cases of one hundred civilian patients with gunshot wounds of the colon treated at the Louisville General Hospital have been reviewed. Most injuries were in the transverse colon (44%), followed by the ascending colon (27%), rectosigmoid (19%), and descending colon (10%). Associated injuries occurred in 81 per cent of the patients; the small bowel was the most common structure injured. Primary closure was used in 52% of the patients, with a resultant 19% rate of wound infection and 14% rate of serious complication. When the extent of contamination or tissue destruction required resection, an attempted primary anastomosis was followed by a high rate of wound infection (57%) and serious complications (36%) as compared with end-colostomy and mucous fistula, which resulted in a 24% rate of wound infection and 24% rate of serious complication. The rate of wound infection between these groups is significant (p = 0.05). Results end-colostomy and mucous fistula were better than with attempted primary anastomosis.