Exteriorized colon anastomosis for unprepared bowel: An alternative to routine colostomy

Table 1 Diagnosis and demographic data of all the patients

	Diagnosis	n	Male	Female	Age (yr)mean ± SD
1	Self-inflicted colon injury	22	22	0	23.6 ± 9.4
23	Trauma (stab wounds and blast trauma)	16	15	1	31 ± 8.6
3	Volvulus sigmoid colon	20	16	4	56.7 ± 7.0
41	Stomach cancer extending to transverse colon	9	7	2	53 ± 9.6
51	Obstructing left colon cancer	14	11	3	54.7 ± 11
6	Amoebic colon abscess	4	3	1	40.7 ± 9.6
7	Endometriosis of left colon	4	0	4	31.2 ± 3.5
8	Ischaemic colitis (post-AAA repair)	4	4	0	57.2 ± 3.3
92	Iatrogenic	6	5	1	31.6 ± 7.7
10	Strangulated ventral hernia	4	0	4	54 ± 2.0
	Total	103	83	20	42.4 ± 16.3

¹Comorbid conditions in 40% of patients in each group e.g. diabetes mellitus, schaemic heart disease, hypertension and chronic obstructive airway disease.

²2 involved hepatic flexure, 3 splenic flexure.

³3 patients involved in blast trauma.

Table 2 Associated injuries in patients presenting with stab wounds

	n
Small bowel injury	5
Stomach injury	2
Mesenteric tear	4
Pneumothorax	2
Liver tear (minor)	2
Total	15

Table 3 Colon Organ Injury Scale¹ (Moore et al, 1990)

Grade		Injury
I	Haematoma	Contusion or haematoma without devascularization
	Laceration	Partial thickness, no perforation
II	Laceration	< 50% of the circumference
III	Laceration	≥ 50% of the circumference without transection
IV	Laceration	Transection of the colon
V	Laceration	Transection of the colon with segmental tissue loss
	Vascular	Devascularised segment

¹Advance one grade for multiple injuries of the same organ.

Table 4 Colon injury grades: In 38 patients involved in stab wounds, blast trauma and self-inflicted injuries

Grade	n
II	4 (10.5%)
III	31 (81.6%)
V	3 (7.9%)

Table 5 Morbidity and mortality

	n
Pulmonary complication	5
Deep vein thrombosis	1
Myocardial infarction & heart failure	3
Incisional hernia	1
Urinary retention	3
Death	1