FREQUENCY OF ANASTOMOTIC LEAKAGE IN PRIMARY REPAIR OF ACUTE COLONIC INJURY

Abstract

Background: Anastomotic leakage remains a significant complication following primary repair of acute colonic injuries. Local data on leakage rates following primary colonic repair in trauma settings is limited, necessitating investigation to inform clinical practice.

Objective: To determine the frequency of anastomotic leakage following primary repair of acute colonic injury and identify associated risk factors.

Methods: A prospective descriptive study was conducted 5^th December 2024 to 5^th June 2025 at Lady Reading Hospital. A total of 142 patients aged 18-70 years with acute colonic injury were enrolled using consecutive sampling. Patients with prior abdominal surgery, morbid obesity, pregnancy, or chronic diseases were excluded. All patients underwent primary repair with standardized techniques. Postoperative monitoring for anastomotic leakage was conducted for 15 days using clinical assessment and CT imaging.

Results: Overall anastomotic leakage frequency was 23.9% (34/142 patients; 95% CI: 17.2-31.7%). Mean age was 42.3 ± 14.7 years with 69.0% males. Blunt trauma was most common (47.2%), followed by firearm injury (30.3%) and stab wounds (22.5%). Penetrating trauma showed significantly higher leakage rates than blunt trauma (29.3% vs 17.9%, p = 0.042). Associated injuries significantly increased leakage rates (29.5% vs 17.2%, p = 0.031). Leakage was associated with prolonged hospitalization (median 19 vs 8 days, p < 0.001), higher reoperation rates (47.1% vs 1.9%, p < 0.001), and increased mortality (11.8% vs 1.9%, p = 0.018).

Conclusion: Anastomotic leakage occurs in nearly one-quarter of patients, with penetrating trauma and associated injuries as significant risk factors, emphasizing the importance of careful patient selection and vigilant monitoring.