DOI:
VOLUME 2, AUGUST ISSUE 6
Noura Zakhour*, Bashar Al khalifa, Ghassan Al khalifa, Maher Bouzo
ABSTRACT
Background: Traumatic colon injuries, although relatively infrequent, are associated with high morbidity and mortality due to the risk of peritoneal contamination, delayed diagnosis, and postoperative complications. Management of these injuries remains a subject of ongoing debate, particularly regarding the selection of surgical technique, the timing of intervention, and criteria for diversion. Objective: This literature review aims to provide a comprehensive analysis of the anatomy, pathophysiology, mechanisms, diagnosis, classification, and surgical management of traumatic colon injuries, emphasizing evidence-based approaches to improve patient outcomes. Methods: Relevant peer-reviewed articles, clinical guidelines, and trauma surgery textbooks published between 2000 and 2024 were systematically reviewed. Key topics included anatomical considerations, histological and physiological features of the colon, mechanisms of injury (blunt, penetrating, and iatrogenic), classification systems such as the Flint Scale, Colonic Injury Score (CIS), and Penetrating Abdominal Trauma Index (PATI), as well as surgical techniques including primary repair, stapled anastomosis, and diversion. Postoperative complications such as wound infection, intra-abdominal abscess, and anastomotic leak were also analyzed. Results: Colon trauma represents 0.1–0.5% of trauma admissions in civilian settings and up to 10–12% in military settings. Most injuries result from penetrating mechanisms, with the transverse and sigmoid colon being most frequently involved. CT scanning with IV and enteric contrast remains the gold standard for diagnosis in hemodynamically stable patients. Primary repair and resection with anastomosis are favored over diversion in most cases, provided contamination is controlled and the patient is stable. Complication rates remain high (infection: 30–50%, abscess: 10–20%, leak: 5–10%). Conclusion: Traumatic colon injuries require a high index of suspicion and prompt surgical management tailored to injury severity, contamination level, and patient physiology. Advances in trauma protocols and surgical techniques have significantly improved outcomes. Future studies should aim to validate standardized scoring systems and refine operative decision-making in resource-limited settings.
Keywords:
Colon injury, abdominal trauma, penetrating trauma, primary repair, colostomy, anastomotic leak, trauma surgery
