Abdominal War Wounds With Large Bowel Involvement: The Medina Hospital Experience

Background: Medina Hospital, a Police Hospital in Mogadishu South, Somalia was closed after the civil war broke out in 1991. With the support of the International Committee of the Red Cross (ICRC), was reopened as community based hospital in 2000. The authors present their experience in the treatment of penetrating abdominal war wounds involving the colon in Medina Hospital.
Methods: A retrospective descriptive study of civilian and military casualties with penetrating abdominal war injuries involving the colon, treated in Medina Hospital from June 2000 to June 2002 was undertaken.
Results: A total of 3496 war wounded patients were treated in Medina Hospital during the period under review. Among them 950 presented with penetrating abdominal war wounds, with large bowel involvement in 430 of them. Initially, 237 (55%) cases of large bowel injury were treated with colostomy; 193 had primary colon closure without any significant increase in the complication rate.
Conclusion: In war situations colostomy may be avoided by performing primary repair of the penetrating large bowel gunshot wounds.