Management of colon injuries

The controversy regarding the management of colon injuries continues, some favouring primary repair while others lean towards a proximal defunctioning procedure. We have reported our experience in this field over a 4-year period. Forty-three patients with large bowel injuries were treated during this period and two of them died in the immediate postoperative period due to continued haemorrhage. Of the remaining 41 patients, 27 underwent primary repair of the colon and 15 per cent of them developed complications. Fourteen patients had a proximal defunctioning procedure and 50 per cent of them developed complications. When severity of injuries was taken into consideration it showed a linear relationship to complications. We conclude that primary repair of the colon should be the preferred method of treatment in patients with grade I and II injuries.