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Revista de la Asociación Médica del Centro Médico ABC

2011, Number 1

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An Med Asoc Med Hosp ABC 2011; 56 (1)

Management of colon trauma by colostomy. Experience of a trauma hospital

Pedroza FJA, Delgadillo GS

Language: Spanish
References: 22
Page: 20-24
PDF size: 51.77 Kb.


ABSTRACT

Background: Colon injuries are increasing do to the rise in violence in big cities, colon injuries have become the organ most injured by trauma. Our objective was to demonstrate that the use of colostomy remains a viable tool in the management of colon injuries due to trauma. Methods: We conducted a retrospective and descriptive study of 23 patients with abdominal trauma and colon lesions during a four year period, from March 1st, 2007 to December 31, 2009 in the Central Hospital of the Red Cross in Mexico. We analyzed all patients with colon lesions, severity of injury, place of lesion, type of wound, evolution over time, morbidity and mortality, hemodynamic state, severity of abdominal contamination, type of surgery, time until intestinal restitution, age and sex. Results: Of a total of 23 patients, 20 were male (86.9%) and 3 were female (13.04%). Average age was 26 years old. Fifteen patients (65.2%) had gunshot wounds, 4 patients (17.4%) stab wounds, and 4 patients (17.4%) abdominal blunt trauma. Eight patients (34.7%) had hemodynamic shock level IV. Mean time until colostomy closure was 5 months, 7 patients did not have colostomy closure. Main colostomy closure procedure used by us was Hartmann in 13 patients. Most common morbidity presented was related to infection in 21.7% of the cases. Mortality presented in one case (4.3%) due to septic shock. Conclusions: Colostomy is still a good procedure in the management of colon injuries, mainly in patients with gunshot wounds. The Hartmann technique is the one we mostly perform due to our experience and the results obtained


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