Direct primary repair of colonic injury Inal-Ramadi teaching Hospital, western Iraq

Abstract

Background: Al Ramadi district, western Iraq was one of the places subjected to military operations that exposed its residents to risk of explosions and indiscriminate fire that increased the risk of penetrating colonic injuries. Objectives: To assess the pattern andmechanism of colonic injuries, other associated organ injuries, age and sex distribution, outcome and efficacy of direct primary repair. Patients and Methods: From all patients with abdominal trauma andcolonic injuries attended Al Ramadi Teaching Hospital during the period from January2014 to September 2014; those who underwent direct primary repair were enrolled in this study. Collected data include age, sex, mechanism and site of colonic injuries,other associated organs injuries, post-operative complications and mortality rate. Descriptive statistics were used to summarize the extracted information. Results: Eighty four patients were included in this study,their age ranged(1-65) years,mean age (30±5) years,58(69.0%)males and26(31.9%) females, out of 65 (77.4%) patients below40 years,50 (59.5%)their age ranged (21-40) years and15(18.9%)in the range of, (1-20)years,74(88.0%)patientshadpenetrating colonic injuries,46(59.7%)had shell trauma,28(33.3%)had bullet injuries,3 (3.6%) blunt trauma. Transverse colon wasthe most common site injured 39 (46.4%), small intestine involved in_31(37%) patients and liver 27(32.1%). post-operative complication noticed in 17 (20.2%), wound infection recorded in 8(9.5%) cases; wound dehiscence 4 (4.8%). The overall mortality recorded 2(2.4%), none of these were related to colon injury. CONCLUSION: Primary repair for colonic injuries is the method of preference for management of colonic injuries as its safe, effective and associated with good results and low mortality rate.