Blunt traumatic injuries to the colon and rectum

Eddy H. Carrillo, Lewis B. Somberg, Cesar E. Ceballos, Miguel A. Martini, Enrique Ginzburg, Jorge L. Sosa, Larry C. Martin

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

BACKGROUND: Experience in the treatment of patients with blunt colonic injuries is based on isolated case reports, and it is unclear whether the principles that guide the management of penetrating colonic injuries should be applied to these patients. Reviews of patients with these injuries suggest that such injuries present unique problems for diagnosis and treatment and are accompanied by excessive morbidity and mortality. STUDY DESIGN: A 42- month retrospective case series was analyzed. RESULTS: Data from 27 patients were analyzed, accounting for 8.5 percent of all colon and rectal injuries and for 0.5 percent of total blunt trauma admissions. Automobile crashes were the cause of injuries in 20 patients (74 percent). The mean Injury Severity Score was 28. All but 2 patients were operated on within 3 hours after admission. No significant difference was found in the morbidity and mortality rates based on the operation performed to manage the colonic injury. Indications for early exploration included a positive diagnostic peritoneal lavage in 23 patients, abnormal radiologic findings in 2, and positive clinical abdominal findings in the remaining 2 patients. CONCLUSIONS: Blunt colonic and rectal injuries are uncommon and pose problems for diagnosis and treatment. Associated injuries are common, and steering wheel compression of the upper abdomen as well as lap belts seem to predispose to colonic injuries. Initial diagnosis is made at the time of operation, and a thorough exploration of the abdominal cavity is important to diagnose associated injuries. Treatment must be individualized; however, based on our observations, the creation of ostomies is not mandatory for the treatment of these injuries.

Original languageEnglish
Pages (from-to)548-552
Number of pages5
JournalJournal of the American College of Surgeons
Volume183
Issue number6
StatePublished - Nov 1 1996

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Nonpenetrating Wounds
Rectum
Colon
Wounds and Injuries
Ostomy
Morbidity
Peritoneal Lavage
Therapeutics
Automobiles
Injury Severity Score
Mortality
Abdominal Cavity
Abdomen

ASJC Scopus subject areas

  • Surgery

Cite this

Carrillo, E. H., Somberg, L. B., Ceballos, C. E., Martini, M. A., Ginzburg, E., Sosa, J. L., & Martin, L. C. (1996). Blunt traumatic injuries to the colon and rectum. Journal of the American College of Surgeons, 183(6), 548-552.

Blunt traumatic injuries to the colon and rectum. / Carrillo, Eddy H.; Somberg, Lewis B.; Ceballos, Cesar E.; Martini, Miguel A.; Ginzburg, Enrique; Sosa, Jorge L.; Martin, Larry C.

In: Journal of the American College of Surgeons, Vol. 183, No. 6, 01.11.1996, p. 548-552.

Research output: Contribution to journalArticle

Carrillo, EH, Somberg, LB, Ceballos, CE, Martini, MA, Ginzburg, E, Sosa, JL & Martin, LC 1996, 'Blunt traumatic injuries to the colon and rectum', Journal of the American College of Surgeons, vol. 183, no. 6, pp. 548-552.
Carrillo EH, Somberg LB, Ceballos CE, Martini MA, Ginzburg E, Sosa JL et al. Blunt traumatic injuries to the colon and rectum. Journal of the American College of Surgeons. 1996 Nov 1;183(6):548-552.
Carrillo, Eddy H. ; Somberg, Lewis B. ; Ceballos, Cesar E. ; Martini, Miguel A. ; Ginzburg, Enrique ; Sosa, Jorge L. ; Martin, Larry C. / Blunt traumatic injuries to the colon and rectum. In: Journal of the American College of Surgeons. 1996 ; Vol. 183, No. 6. pp. 548-552.
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