In 94 civilian colonic injuries modes of treatment were variable, ranging from double-barreled colostomy to primary repair with or without exteriorization. Multiplicity of associated injuries, especially vascular, shock, and infection, determined both morbidity and mortality. The overall morbidity was 29% and mortality 13%. The majority of complications were infectious and included intra-abdominal abscess, wound infection, and septicemia. The most common causes of death were hemorrhagic shock and sepsis.
The data from this series do not support the dogmatic approach of "colostomy only" as the only acceptable method of management of colonic injuries. Primary repair with or without exteriorization in selected cases reduces morbidity, length of hospitalization, and the necessity for secondary operations.
Garfinkle SE, Cohen SE, Matolo NM, Getzen LC, Wolfman EF. Civilian Colonic InjuriesChanging Concepts of Management. Arch Surg. 1974;109(3):402-404. doi:10.1001/archsurg.1974.01360030054015