Objective: This study aims to evaluate the surgical treatment methods and outcomes in patients with colon injuries following blunt and penetrating abdominal trauma.

Materials and Methods: Twenty-five patients who underwent surgery for abdominal trauma and were found to have colon injury in our clinic between January 2018 and January 2023 were retrospectively analyzed.

Results: The mean age of the 25 patients was 37±11.4 years (range, 19-74), and 22 (88%) were male. Penetrating abdominal trauma was present in 20 patients (80%), while 5 patients (20%) had blunt abdominal trauma. The most common site of injury was the transverse colon in 11 patients (44%), followed by the rectum in 7 patients (28%). Additional organ injury was detected in 14 patients (56%), most frequently involving the small bowel in 4 patients (16%). The mean Colon Injury Severity Score of the cases was 3.32, and the mean Penetrating Abdominal Trauma Index was 17.4. Primary repair or anastomosis was performed in 18 patients (72%), while fecal diversion (anastomosis or primary repair) was performed in 7 patients (28%). Complications occured in 7 patients (28%), and the mortality rate was 4%.

Conclusion: Fecal diversion should be considered only in high-risk cases of colon injury. In penetrating trauma, avoidance of fecal diversion is recommended in hemodynamically stable patients with proximal colon injuries who do not require transfusion. Larger, multicenter studies are needed to determine the optimal surgical management of colon injuries.