Primary repair versus diversion in penetrating colon injuries

Abstract

Back ground: In Iraq, after 2003 had more
accidents of the shell, bullet and stab abdominal
wounds, more over colon injuries.
Objective: The aim of this study is to evaluate
the most appropriate management of penetrating
colon injuries, comparing the primary repair with
the diversion.
Methods: Eighty patient series with shell, bullet
and stab colonic injuries during 4.5 years period
from June 2006-december 2010 at Al-Yarmouk
teaching hospital. The study compared the use of
primary repair versus diversion, analyzing
variables such as sex, age, severity of injury and
mortality rate.
Results: there were total 80 patients ,62 (77.5%)
male and 18(22.5%) female .male :female ratio
3.4:1. the most affected age group was 21-30
years. 47 patients 58.75% were shell injuries.28
patients 35% were bullet injuries. 5 patients
6.25% were stab wounds. 46 patients 57.5%
managed by primary repair ,one of them 1.25%
died, while diversion in34patients 42.5%
different grades of colon injuries ,5 of them
6.25% died ,this was due to different factors such
as multiple organ injuries and post operative
complications.
Conclusion: the primary repair is safe and
effective regarding morbidity and mortality in
the management of grade II, III penetrating colon
injuries with minimal risk factors as compared to
diversion.