Blunt colonic injury—a multicenter review

Steven E. Ross, Roy A. Cobean, David B. Hoyt, Richard Miller, Peter Mucha, John A. Pietropaoli, H. Leon Pachter, Thomas H. Cogbill, Eric J. Demaria, Keith F. O’malley, Gregory J. Jurkovich, Richard K. Simons, Steven D. Shotts, Deborah Boorse, Steven R. Shackford, Amber Guth, Jeffrey Landercasper, Harvey J. Sugerman, Diane Mac Kenzie

Research output: Contribution to journalArticlepeer-review

61 Scopus citations


During the past decade there has been a shift in the management of injuries of the colon to primary repair without a protective diverting colostomy. Unfortunately, reports concerning this practice contain relatively few patients with blunt trauma and it is unclear whether the principles established for penetrating injury should be applied in the setting of blunt colon injury. A retrospective review of 54,361 major blunt trauma patients admitted to nine regional trauma centers from January 1, 1986, through December 31, 1990, was conducted. Statistical analysis of the data collected regarding 286 (0.5%) of these patients who suffered colonic injury revealed: (1) injury to the colon is found in more than 10% of patients undergoing laparotomy following blunt trauma; (2) available diagnostic modalities are unreliable in detecting isolated colonic pathology; (3) primary repair of full-thickness injuries or resection and anastomosis may be safely performed without diversion; (4) gross fecal contamination is the strongest contraindication to primary repair. Further, delay of surgery, shock, and the timing of antibiotic administration were not associated with significantly increased morbidity.

Original languageEnglish (US)
Pages (from-to)381-384
Number of pages4
JournalJournal of Trauma - Injury, Infection and Critical Care
Issue number3
StatePublished - Sep 1992
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine


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