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Outcome of primary repair in penetrating colonic injuries
Muhammad Ibrar Hussain1, Muhammad Zahid, Hasan Askri
1Department of Surgery, Surgical Unit II, Lahore General Hospital, Lahore.
Objective:
To assess the outcome of primary repair in penetrating colonic injuries in terms of regional/local morbidity (suture line breakdown, intra-abdominal abscess) and mortality.
Design:
Prospective, interventional study.
Place And Duration Of Study:
Surgical Unit II at Lahore General Hospital, Lahore, over a period of 3 1/2 years from June 1999 to December 2002.
Patients And Methods:
Out of 38 consecutive patients with penetrating colon injuries, a selective group of 25 patients (65.7%) undergoing primary repair (simple suture, resection and anastomosis without covering colostomy and right hemicolectomy) were included in this study. The morbidity and mortality variables were recorded and statistically analyzed.
Results:
Majority of our patients were of younger age group (mean 25 years). Twenty patients (80%) were male. The commonest mode of injury was firearm injury (72%). The time interval between injury and repair was 3-11 hours (mean 7 hours). Simple repair of colon with interrupted stitches was the commonest procedure performed (44%), followed by right hemicolectomy (32%). Colon related complications developed in 3 patients (12%), which included two fecal fistulae and one intra-abdominal collection. One patient died of septicemia (4%). Hospital stay ranged between 6-16 days (mean 8 days).
Conclusion:
Primary repair is a safe method of managing penetrating colon injuries in carefully selected patients.
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