Treatment of war injuries to the colon: primary resection and anastomosis without relieving colostomy.

Fourteen casualties with penetrating injuries to the colon caused by firearms in combat zones have been treated according to the principles accepted today for the treatment of such injuries acquired in civilian violence. The patients were treated by primary resection of the injured part of the intestine, without relieving colostomy, providing that the time interval between the moment of injury and admittance to the hospital was less than six hours. Ten patients fulfilled this criterion, while three patients with prolonged time intervals were treated by resection and colostomy, and one by exteriorization. Overall mortality was 14.3%, and correlated to the injury severity score. Complications related to colon surgery occurred in one patient (7%). Primary resection without relieving colostomy for the colon injuries caused by firearms is a safe procedure providing that the time interval between wounding and surgery does not exceed six hours.