Colon trauma: Royal Melbourne Hospital experience

BACKGROUND: Recent studies from the USA and South Africa suggest that primary repair or resection and primary anastomosis have become the recommended treatment for most traumatic colon injuries. The aim of the present review is to determine the applicability of these studies to the urban Australian setting. METHODS: All patients with colon injuries operated on at the Royal Melbourne Hospital from March 1989 to March 1999 were identified. Data were collected by a retrospective chart review. RESULTS: A total of 20 patients sustained 26 injuries to the colon. Blunt injuries were more common than penetrating injuries (14 vs 6). Significant other injuries occurred in 15 patients. Colostomies were performed in four patients. The overall mortality rate was 10%. There were no anastomotic leaks. Primary repair or resection and primary anastomosis were not associated with any increase in intra-abdominal complications. CONCLUSION: Evidence from large trauma centres supporting primary repair or resection and primary anastomosis is also applicable to regions that have a low rate of traumatic colon injury.