Authors performed a retrospective analysis on 19 patients with colon injuries(12 blunt and 7 penetrating injuries) and 10 patients with perineal injuries (5 blut and 5 penetrating injuries) who had been surgically treated between 1989 to 1994 at
the
Department of Surgery, Capital Armed Fores General Hospital. In colonic injuries, ascending and sigmoid colon were the most commonly in juried segnent, occurring in 6 cases respectively, with the small bowel being the most frequent associated
intraabdominal organ injured. In perineal injuries, all 5 blunt injury cases had associated pelvic bone fractures, while there were no associated organ injuries in penetratting injuries. Orgna injury scale(OIS) for blunt colonic injuries was
Grade
I :
5, Grade II : 4, Grade III : 1, Grade V : 2, while OIS for penetrating injuries was grade Ⅱ: 5 and GradeⅢ: 2 cases. Penetrating abdominal trauma index(PATI) was significantly higher in blunt as compared to penetrating colonic injuries(28.4±3.8
vs.,
17.3±2.8, p<0.05), while there was no significant difference in injury severity score. In colonic injuries, primary repair was performed in 9 cases (Grade I : 5, GradeⅡ: 3, GradeⅢ: 1), while staged repair was performed in 10 cases (GradeⅡ: 6,
GradeⅢ: 2, GradeⅤ: 2). Postoperative complications occured in 4(44%) of primary repair cases and in 6 (60%) of staged operation cases, with the wound infection being the most common. In blunt perineal injury, all patients were treated by
anoplasty,
drainage and colostomy while all penetrating perineal injury patients were treated by drainage alone. One patient with blunt perineal injury died due to eptic complication and 3 other patients with blunt perineal injury developed incontinence.
Our data indicates that based on careful patient selection, morbidity rate following primary repair for colonic injuried are comparable to staged repair.
For blunt perineal injuries, presservation of sphincter function determines the longterm out come of the patients.
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