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Primary repair of colorectal injuries in childhood

M S Slim, M Makaroun, A R Shammá

    Journal of Pediatric Surgery
    |December 1, 1981
    PubMed

    Insights

    This study on pediatric colorectal injuries from ballistics found primary repair had a 16.6% mortality, while colostomy had 10%. Colostomy was safer for patients with additional injuries.

    Area of Science:

    • Pediatric Surgery
    • Trauma Surgery
    • Colorectal Surgery

    Background:

    • Colorectal perforating injuries in children due to ballistics are severe trauma.
    • Management strategies for these injuries require careful consideration.

    Purpose of the Study:

    • To evaluate outcomes of primary repair versus colostomy for pediatric colorectal perforating injuries.
    • To identify factors influencing survival and hospital stay.

    Main Methods:

    • Retrospective survey of 44 pediatric patients with colorectal perforating injuries.
    • Analysis of surgical management (primary repair vs. colostomy) and outcomes.
    • Assessment of factors like injury location, additional injuries, and shock on survival.

    Main Results:

    • Primary repair had a 16.6% mortality; colostomy had a 10% mortality.
    • Colostomy was associated with lower mortality (11% vs. 21%) in patients with additional injuries.
    • Shock adversely affected survival; hospital stay was shorter with primary repair (24 days) vs. colostomy (36 days).

    Conclusions:

    • Colostomy may be a safer option for pediatric colorectal perforating injuries, especially with associated injuries.
    • Prompt surgical intervention within 7 hours is crucial.
    • Hemodynamic stability is a critical determinant of survival in these pediatric trauma cases.

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