Colon and rectal trauma

: From July 1982 to June 1989, 64 patients with trauma involving a colon and rectum operated on at the Kaohsiung Medical College Hospital were retrospectively reviewed. Their ages ranged from 14 to 90 years (mean 43.6 +/- 17.6 years); 48 were male, 16 female. Thirty-four (53.1%) had penetrating injuries, 30 (46.9%) had blunt injuries. Twenty-six (86.7%) blunt injuries and 7 (20.6%) penetrating injuries involved various associated injuries. There was a significantly greater number of associated organ injury in cases of blunt trauma. The most common organ injured concomitantly was the small intestine. The severity of injury and general condition were quantified for each patient using the intraoperative grading system proposed by Flint et al, and revealed that it was independent of the colorectal site, but related to the mode of trauma. After an assessment of the grade of injury, 42 patients underwent colostomies, 14 primary closures, 2 resections and anastomoses and 6 exteriorized repairs In the primary closure group, there was no mortality but 2 suture leakages which reoperated to colostomies. In three patients (50%) of the exteriorized repair group with fecal leakage developed at the repair site, the exteriorized loops were coverted into colostomies without complication. The most common complications were wound infection and abdominal abscess. The mortality (14.1%) and morbidity (45.3%) were not related to the location of the injured bowel but were influenced by the grade of colorectal trauma, associated organ injury and the mode of trauma.(ABSTRACT TRUNCATED AT 250 WORDS)