Gunshot wounds of the colon: role of retained bullets in sepsis.

The role in the development of local sepsis of retained bullets that have passed through the colon was investigated. Of 84 patients with gunshot wounds of the colon, the bullet was retained in the body in 40 and had left or was removed from the body in 44. The groups were similar with regard to Revised Trauma Score, Injury Severity Score, Penetrating Abdominal Trauma Index and type of colonic trauma. The incidence of major local complications was 5 per cent in patients with a retained bullet and 7 per cent in those without. These results suggest that retained bullets that have penetrated the colon do not contribute to local septic complications.