Emergency right colon resection

F. B. Miller, N. R. Nikolov and R. N. Garrison

Controversy exists over the management of the stoma following emergency right colonic resection. To define the stoma management following colon resection, 70 patients who underwent an emergency right colectomy were studied retrospectively. Thirty-six underwent a primary anastomosis and 34 received a diversion with an ileostomy. Indications for resection were as follows: penetrating injury, 28 patients; blunt injury, five patients; obstruction, 13 patients; perforation, 15 patients; vascular injury, seven patients; and hemorrhage, two patients. The mortality was equal in both groups (21%). Severe morbidity directly related to the ileostomy was noted in six patients (18%), and three leaks (8%) were noted in the anastomotic group. High mortality continues to be associated with emergency right colon resection, regardless of the indication for the procedure. This high death rate is not lowered by diversion in deference to an anastomosis.