کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3241734 1206089 2010 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Current management of large bowel injuries and factors influencing outcome
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی طب اورژانس
پیش نمایش صفحه اول مقاله
Current management of large bowel injuries and factors influencing outcome
چکیده انگلیسی

BackgroundColonic and intra-peritoneal rectal injuries may be managed by primary repair and extra-peritoneal rectal injuries by diverting colostomy. This study was undertaken to document our experience with this approach and to identify factors which might impact on outcome.Patients and methodsProspective study of all patients treated for colon and rectal injuries in one surgical ward at King Edward VIII hospital, Durban, over a 7-year period (1998–2004). Demographic data, clinical presentation, findings at laparotomy and outcome were documented.ResultsOf 488 patients undergoing laparotomy, 177 (36%) had injuries to the colon and rectum with age 29.8 ± 10.9 years. Injury mechanisms were firearms (118) stabs (54) and blunt trauma (5). Delay before laparotomy was 10 ± 9.3 h. Complication and mortality rates were 36% and 17%, respectively. 68 patients (38%) required ICU management. Shock on admission and increased transfusion requirements were associated with a significantly increased mortality. Patients with delay ≤12 h before laparotomy had a higher mortality rate than those with delay >12 h. The mortality rate increased with the number of associated injuries and it was higher the higher the Injury Severity Score (ISS); it was similar for stabs, firearms and blunt trauma. Hospital stay was 9.5 ± 9.2 days.ConclusionWe reaffirm that primary repair is appropriate for colonic and intra-peritoneal rectal injuries and that extra-peritoneal rectal injuries require diverting colostomy. Shock on admission, increased blood transfusion requirements, associated organ injury and severity of the injury were associated with high mortality.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Injury - Volume 41, Issue 1, January 2010, Pages 58–63
نویسندگان
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