Colorectal Trauma: From Incidence to Definitive Treatment of Patients Treated in a Tertiary Hospital in the Federal District

Abstract Colorectal trauma presents a significant clinical challenge due to its complexity and high morbidity. Although well-documented in international literature, data on its incidence and management in Brazil—particularly in the Federal District—remain scarce. To determine the incidence, causes, and treatment approaches of colorectal trauma in patients treated at a tertiary hospital in Brasília, Brazil, over a five-year period. Methods: This retrospective cohort study analyzed medical records of patients aged ≥18 years diagnosed with colorectal trauma and treated at the Regional Hospital of Taguatinga from January 2020 to January 2025. Data on demographics, mechanisms and types of injury, injury severity, and treatment were collected. Statistical analysis included descriptive and inferential tests with a significance level set at p < 0.05. A total of 40 patients was included. The majority were male (82.05%) with a mean age of 32.39 ± 10.04 years. Most injuries (92.5%) were due to penetrating trauma, especially gunshot wounds (50%) and stab wounds (42.5%). The transverse colon was the most frequently affected site (37.5%). Transfixing injuries were the most common type (51.72%). The mean Injury Severity Score (ISS) was 45.31 ± 25.06. Primary repair was the most common surgical approach (47.37%), followed by resection with anastomosis (26.32%) and colostomy (10.53%). A significant association between gender and trauma mechanism was observed (p = 0.026), with men more often suffering firearm injuries and women more likely to experience blunt trauma. Findings align with global trends, highlighting the predominance of penetrating trauma and a shift toward conservative surgical approaches like primary repair. The results underscore the need for public health strategies targeting firearm-related violence and emphasize the importance of national guidelines adapted to the Brazilian context.