Investigation of Risk Factors Affecting Surgical Decision in Traumatic Colon Injuries

Background: Management of colon injuries in trauma surgery has not yet been standardized. Our aim is to present our findings in patients with colon injury retrospectively in order to contribute to the selection of a surgical algorithm. Methods: Patients were evaluated with regard to age, sex, type of trauma, hemodynamic state, the time period between trauma and surgery, amount of transfusion; additional organ injury, localization and severity of colon injury, fecal contamination, surgical procedures, postoperative complications, and mortality, and then the factors affecting morbidity and mortality were investigated. Results: Mean Abdominal Trauma Index (ATI) of 34 cases was 18.9; ATI was over 25 in 6 (18%) cases. The time period between trauma and surgery was over 8 hours in 2 (6%) cases. Mean Colonic Injury Severity Scale (CISS) was 3. Severe fecal contamination was detected in 4 (12%) cases. Primary repair and colostomy were performed in 26 (76.5%) and 8 (23.5%) cases, respectively. Mortality occurred in 2 cases who had received colostomy procedure. Conclusions: Decision of performing either primary repair or resection anastomosis should depend particularly on CISS (which should be equal to or less than III) accompanied by low ATI, prompt admittance (i.e. within the first 8 hours), and little or no fecal contamination.