Management of penetrating colorectal injuries in civilian practice

Abstract

The changing trend in the management of penetrating colorectal trauma favouring primary repair without faecal diversion has generated a lot of interest among surgeons. In West Africa, surgeons face peculiar challenges of inadequate facilities, late presentation, delay to surgery and faecal loading of the colon. This study was carried out to determine the place of this trend in our practice. There were seventeen consecutive patients (aged 15 to 50 years) with injuries at 21 different anatomic sites: five in the right colon and 16 in the left. Twelve (75%) patients had primary repair without faecal diversion, two of which had colon related complications. The median duration of hospitalisation was shorter in patients managed without faecal diversion. Two patients died in the immediate peri-operative period and could not be included in the study. From our experience and from a review of literature we conclude that primary repair without faecal diversion should be favoured in good surgical risk patients.



Key Words: Colon, rectum, injury, primary repair, colostomy

(Jnl Med. & Biomed Res.: 1(2) 2002: 12-17)