Abstract
A retrospective study is presented of 119 patients admitted to the Central Hospital of the Venezuelan Institute of Social Security, in Caracas, between 1982 and 1990, with the diagnosis of colon trauma. Several parameters including age, etiology, time elapsed between the accident or assault and hospital admission, preoperative and postoperative hemoglobin and diastolic blood pressure, associated lesions, procedure practiced, complication rate, and hospital mortality are reviewed. The second and third decades of life appear most often involved. Most patients reached the hospital within the first four hours of the accident or assault. Anemia, sustained diastolic hypotension, and number of organs involved in addition to the colon were important prognostic factors for complications. Apparently the surgical procedure, with simple suture or resection, mostly without “protective” colostomy, was not very relevant. Hospital mortality was 2.4 percent. A staging system based on clinical conditions for decision making in the operating room was used in an attempt to inject some objectivity into the surgical approach.
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References
Flint LM, Vitale GC, Richardson JD, Polk HC. The injured colon. Relationships of management to complications. Ann Surg 1981;193:619–23.
Ryan GA, Garrett JW. A quantitative scale of impact injury. CAL No. VJ-1823-R34 Buffalo, Cornell Aeronautical Laboratory, 1968.
Baker SP. Evaluation of medical care of the injured. J Trauma 1971;11:892–4.
Committee on Medical Aspects of Automotive Safety. Rating the severity of tissue damage, I. The Abbreviated Scale. JAMA 1971;215:277–80.
Baker SP, O'Neill B, Haddon W, Long WB. The Injury Severity Score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma 1974;14:187–96.
Moore EE, Dunn EL, Moore JB, Thomson JS. Penetrating Abdominal Trauma Index. J Trauma 1981;21:439–45.
Morgado PJ, Hamana N, Ortega M, Valery N. Traumatismos del intestino grueso. Experiencia en el Hospital Central del Instituto Venezolano de los Seguros Sociales. Rev Esp Enferm Apar Dig 1985;67:165–70.
Fajardo-Ortiz G. Teoría y práctica de la administración de la atención médica y de Hospitales. Mexico City: Prensa Médica Mexicana, 1970:157–8.
Barquin M. Dirección de Hospitales. Mexico City: Nueva Editorial Interamericana, 1972:280–1.
Clemente A, Barbato V, Alfaro LA, Ruiz JM. Complicaciones de la colostomía. Rev Soc Venez Cir 1986;39:35–8.
Morgado PJ, Alfaro R. Colostomías. Experiencia en el Hospital Central del IVSS. Cent Médico 1984;79:215–22.
Ferro R, Lobo P. Heridas de colon en el Hospital Universitario de los Andes. Rev Venez Cir 1979;32:78–81.
di Natale I, Corsini A. Surgical management of traumatic injuries of the colon: a report. Coloproctology 1990;5:309–11.
Summaries, International Surgical Week, Societe Internationale de Chirurgie, Paris, 1985.
Burch JM, Brock JC, Gevirtzman L,et al. The injured colon. Ann Surg 1986;203:701–11.
George SM, Fabian TC, Voeller GR, Kudsk K, Mangiante EC, Britt LG. Primary repair of colon wounds. A prospective trial in nonselected patients. Ann Surg 1989;209:728–34.
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Read at the XII Latin American Congress of Coloproctology, Las Leñas, Argentina, July 1 to 4, 1991.
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Morgado, P.J., Alfaro, R., Morgado, P.J. et al. Colon trauma—Clinical staging for surgical decision making. Dis Colon Rectum 35, 986–990 (1992). https://doi.org/10.1007/BF02253503
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DOI: https://doi.org/10.1007/BF02253503