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Article
May 1982

Trauma of the ColonEarly Drop-Back of Exteriorized Repair

Author Affiliations

From the Department of Surgery, Valley Medical Center, Fresno, Calif, and the Department of Surgery, University of California School of Medicine, San Francisco.

Arch Surg. 1982;117(5):652-656. doi:10.1001/archsurg.1982.01380290098017
Abstract

• Exteriorized repair of selected colonic injuries has been reported to be successful. Eighty-two colonic injuries were reviewed to determine the indications for primary repair, exteriorized repair, or colostomy and to assess the feasibility of early drop-back of the exteriorized repaired colon. Injuries were graded into three stages: stage 1, good risk; stage 2, moderate risk; and stage 3, bad risk. Sixty-seven percent of patients with stage 1 injuries underwent primary repair, 61% of patients with stage 2 injuries underwent exteriorized repair, and 61% of patients with stage 3 injuries received a colostomy. Of 38 patients who had exteriorized repair, 29 (76%) had their colon successfully dropped back on an average of five days postoperatively. Nine patients had their exteriorized colon converted to a colostomy on an average of 5.5 days postoperatively. The overall mortality was 2.4%; however, the mortality of the patients with exteriorized repair was 0%. Exteriorized repair with early drop-back is safe and economical for most patients with stage 2 injuries and selected patients with stage 3 injuries.

(Arch Surg 1982;117:652-656)

References
1.
Schrock TR, Christensen M:  Management of perforating injuries of the colon . Surg Gynecol Obstet 1972;135:65-68.
2.
Stone HH, Fabian TC:  Management of perforating colon trauma: Randomization between primary closure and exteriorization . Ann Surg 1979;190:430-436.Article
3.
Mulherin JL, Sawyers JL:  Evaluation of three methods for managing penetrating colon injuries . J Trauma 1975;15:580-587.Article
4.
Kirkpatrick JR, Rajpal SG:  The injured colon: Therapeutic considerations . Am J Surg 1975;129:187-191.Article
5.
Lou MA, Johnson AP, Atik M, et al:  Exteriorized repair in the management of colon injuries . Arch Surg 1981;116:926-929.Article
6.
Abcarian H, Lowe R:  Colon and rectal trauma . Surg Clin North Am 1978;58:519-537.
7.
Flint LM, Vitale GC, Richardson JD, et al:  The injured colon: Relationships of management to complications . Ann Surg 1981;193:619-623.Article
8.
Yajko RD, Norton LW, Bloemendal L, et al:  Morbidity of colostomy closure . Am J Surg 1976;132:304-306.Article
9.
Schrock TR, Deveney CW, Dunphy JE:  Factors contributing to leakage of colonic anastomoses . Ann Surg 1973;177:513-518.Article
10.
Hunt TK, Hawley PR:  Surgical judgement and colonic anastomoses . Dis Colon Rectum 1969;12:167-171.Article
11.
Patton TB, Lyons C:  The treatment of traumatic injuries of the colon . J Trauma 1961;1:298-305.Article
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