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Primary repair or colostomy in the management of civilian colonic trauma.

BACKGROUND
Management of civilian colonic trauma remains controversial.


AIM
To determine prognostic factors in patients with civilian colonic trauma undergoing different modes of therapy.


METHODS
Sixty-five patients with colonic injuries were retrospectively analyzed.


RESULTS
Right and left colon injuries were present in 30 and 35 cases respectively. Colon-related complications occurred in 27.7%. One death (1.5%) was directly due to colonic injuries. Left sided colon injuries led to a higher incidence of complications and longer duration of hospital stay; a higher number of complications occurred in relation to colostomy than primary closure.


CONCLUSIONS
Primary repair can be done in more cases than is routinely done. The presence of multiple abdominal injuries or shock does not exclude primary repair. The site of injury may affect the outcome, but does not exclude primary repair. Gross fecal contamination, extensive colonic damage and type of feces in affected colon should be considered as indications favoring colostomy.