03-13-2006, 04:16 AM
A 25-year-old man is involved in a gang shootout and sustains an abdominal gunshot wound from a .22 pistol. At laparotomy, it is discovered that the left transverse colon has incurred a through-and-through injury with minimal fecal soilage of the peritoneum. Which consideration best guides your operative approach?
A. A colostomy should be performed for colonic injury in the presence of gross fecal contamination
B. The presence of shock on admission or more than two associated intraabdominal injuries is an absolute contraindication to primary colonic repair
C. Distal sigmoidal injuries should not be repaired primarily
D. Right-sided colonic wounds should not be repaired primarily
E. Administration of intravenous antibiotics with aerobic and anaerobic coverage has not been shown to decrease the incidence of wound infections after repair of colonic injuries
A. A colostomy should be performed for colonic injury in the presence of gross fecal contamination
B. The presence of shock on admission or more than two associated intraabdominal injuries is an absolute contraindication to primary colonic repair
C. Distal sigmoidal injuries should not be repaired primarily
D. Right-sided colonic wounds should not be repaired primarily
E. Administration of intravenous antibiotics with aerobic and anaerobic coverage has not been shown to decrease the incidence of wound infections after repair of colonic injuries