Maqbool Ahmad, Muhammad Misbah Rashid, Fareed Khan, Mohammad Ahmad.
Primary Repair of Intraperitoneal Colonic injuries in the presence of risk factors.
J Coll Physicians Surg Pak Jan ;12(4):227-31.

Objective: To determine the safety/results of primary repair of colonic injuries in the presence of risk factors. Design: A retrospective study. Place and Duration of Study: This study was conducted during the period of September 1994 to April 2001. Methods: Sixty-two cases were operated for intraperitoneal colonic injuries, the majority were due to high velocity bullets or splinters. Primary closure after debridement was performed in 33 cases while resection and anastomosis was carried out in 22 cases. In 4 cases right hemicolectomy was done and only 3 cases were managed with colostomy. Results: Thirty-six patients had one or more associated risk factors. The right colon was most commonly injured and small gut perforation was the most commonly associated injury. Wound infection was the most common complication (32.2%). Mortality was 4.8% (3 cases). These patients died due to haemorrhage and shock associated with liver and vascular trauma and unrelated to colonic injury or its mode of treatment. Conclusion: Nearly all colonic injuries can be safely managed with primary repair even in the presence of risk factors except in patients who are haemodynamically unstable and have serious associated injuries.

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