War injuries of the colon and rectum

During the war in Croatia, 77 wounded with colon (64) and rectum (13) injuries were treated at Osijek Hospital in the Department of Surgery from June 1991 to September 1992. Shrapnel wounds accounted for 68.8% of the injuries. Forty-seven (61.0%) had unilocular penetrating injury, 15 (19.5%) had multilocular penetrating injuries, 10 (13.0%) had crush injuries, and 5 (6.5%) had contusion of the colon. All who died (14) had associated intra-abdominal and other injuries. Primary repair was possible for 7 (9.1%) injuries, while 4 (5.2%) were repaired and extraperitonealized, 19 (24.6%) exteriorized injuries, 17 (22.1%) were resected followed by oral derivation, 21 (27.2%) sutured followed by oral derivation, and 6 (7.8%) had resection and anastomosis. In 3 (3.9%) patients no colon repair was performed as they died on the table. We had 13 (16.9%) complications and 14 (18.2%) mortalities, 11 (14.3%) postoperatively including 9 within the first 24 h after surgery.