Treatment of choice for stab injury caecum ?
Ans. is 'b' i.e., ileo-transverse anastomosis These options mentioned in the question are of the year 1989; no longer seems to be valid. The management of Colonic injuries in latest edition of Schwaz is: Currently 3 methods for managing the colonic injuries are used? a. Primary repair (it includes lateral suture repair or resection of the damaged segment with reconstruction by ileocolostomy or colocolostomy) b. End colostomy c. Primary reapir with diveing ileostomy Various trials have proven that the Primary repair is safe and effective in viually all patients with penetrating wounds. Schwaz writes- "Numerous large retrospective and several prospective studies have now clearly demonstrated that primary repair is safe and effective in viually all patients with penetrating wounds. Colostomy is still appropriate in a few patients, but the current dilemma is how to select which patients should undergo the procedure. Currently, the overall physiologic status of the patient, rather than local factors, directs decision making. Patients with devastating left colon injuries requiring damage control are clearly candidates for temporary colostomy. Ileostomy with colocolostomy, however, is used for most other high-risk patients."
Caecostomy
Ileo-transverse anastomosis
Transverse colostomy
Sigmoid colostomy