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Review
. 2018 Jan;31(1):11-16.
doi: 10.1055/s-0037-1602175. Epub 2017 Dec 19.

Colon Trauma: Evidence-Based Practices

Ryo Yamamoto  1 , Alicia J Logue  2 , Mark T Muir  1
Affiliations
Review

Colon Trauma: Evidence-Based Practices

Ryo Yamamoto et al. Clin Colon Rectal Surg. 2018 Jan.

Abstract

Colon injury is not uncommon and occurs in about a half of patients with penetrating hollow viscus injuries. Despite major advances in the operative management of penetrating colon wounds, there remains discussion regarding the appropriate treatment of destructive colon injuries, with a significant amount of scientific evidence supporting segmental resection with primary anastomosis in most patients without comorbidities or large transfusion requirement. Although literature is sparse concerning the management of blunt colon injuries, some studies have shown operative decision based on an algorithm originally defined for penetrating wounds should be considered in blunt colon injuries. The optimal management of colonic injuries in patients requiring damage control surgery (DCS) also remains controversial. Studies have recently reported that there is no increased risk compared with patients treated without DCS if fascial closure is completed on the first reoperation, or that a management algorithm for penetrating colon wounds is probably efficacious for colon injuries in the setting of DCS as well.

Keywords: blunt colon injury; damage control surgery; destructive colon injury; nondestructive colon injury; ostomy.

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Figures

Fig. 1
Fig. 1
Management of colon injury. *Penetrating destructive colon injury includes wounds involving 50% or greater of the colon wall circumference or devascularization. Blunt destructive colon injury includes serosal wounds involving 50% or greater of the colon wall circumference, devascularization, or full-thickness perforations. DCS, damage control surgery; U, unit.
See this image and copyright information in PMC

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