Right hemicolectomy and peritoneal lavage in missile injuries of the right colon.

Missile injury of the right colon is a serious condition. Extensive bowel damage and faecal soiling are the main problems in managing these cases. The operative management and complications of 50 cases of war injury of the right colon were studied. Resection with primary anastomosis and antibiotic peritoneal lavage was performed in all cases. Thirty-seven (74%) had associated injuries other than the right colon. 5/50 (10%) developed septicaemia. There were 4 infected wounds (8%), 2 cases of irreversible shock (4%), 2 patients with cellulitis of the abdominal wall (4%) and one patient (1%) with respiratory failure, bleeding stress ulcers, intraperitoneal abscess or chest infection, 5/50 (10%) died, only two (4.25%) of them from causes related to their colonic injury. Our experience proves that right hemicolectomy with primary end-to-end anastomosis and peroperative antibiotic peritoneal lavage is a safe one-stage method in managing missile injuries of the right colon with peritoneal faecal soiling.