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Primary Repair or Fecal Diversion for Colorectal Injuries After Blast: A Medical Review

Published online by Cambridge University Press:  28 May 2014

Michelangelo Bortolin ,
Ludovica Baldari ,
Maria Grazia Sabbadini  and
Nobhojit Roy
Michelangelo Bortolin*
Affiliation:
Università Vita-Salute San Raffaele, Milan, Italy Servizio Emergenza Territoriale 118 Torino, Grugliasco, Italy
Ludovica Baldari
Affiliation:
Università Vita-Salute San Raffaele, Milan, Italy
Maria Grazia Sabbadini
Affiliation:
Università Vita-Salute San Raffaele, Milan, Italy
Nobhojit Roy
Affiliation:
Department of Surgery, BARC Hospital, Mumbai, India Jamsetji Tata Centre for Disaster Management, School of Habitat | Tata Institute of Social Sciences, MumbaiIndia
*
Correspondence: Michelangelo Bortolin, MD Università Vita-Salute San Raffaele Via Olgettina 60–20132 Milano, Italy E-mail michelangelo.bortolin@gmail.com
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Abstract

Blast injury is a frequent cause of injury during armed conflicts, and the force of a blast can cause closed colorectal injury and perforation.1 After identification of a blast-related colorectal injury, the surgical options are primary repair or fecal diversion with the option for secondary repair. This structured review was conducted to determine which patients could be treated with primary repair (PR) or with fecal diversion. The review method followed the Prisma Statement method for medical systematic review. All data from the relevant articles were collected in a single database. Articles took into account wars in Bosnia, Iraq and Afghanistan from January 1993 through November 2012. The review was limited due to lack of reported data, hence qualitative analysis was the main review method. The review showed that for patients who do not have associated intra-abdominal injuries (diaphragm, stomach, pancreas, spleen, or kidney) or hemodynamic instability, PR did not result in an increase of complications or mortality.

BortolinM, BaldariL, SabbadiniMG, RoyN. Primary Repair or Fecal Diversion for Colorectal Injuries After Blast: A Medical Review. Prehosp Disaster Med. 2014;29(3):1-3.

Keywords

blastcolorectal woundsdisaster medicineprimary repair
Type
Special Report
Information
Prehospital and Disaster Medicine , Volume 29 , Issue 3 , June 2014 , pp. 317 - 319
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2014 

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