Abstract
The management of traumatic colonic and rectal injuries is an interesting study in the evolution of trauma care in general. The care for patients suffering from colorectal trauma has been influenced by what we have learned from experience during wartime. As will be covered, diversion of colorectal trauma through the liberal use of ostomies has fallen out of favor of late – and the trend is now favoring increased use of primary repair of these injuries.
There are different considerations to take in to account in the surgical management of the patient with colorectal trauma. Different considerations between blunt and penetrating injuries are important, as well as differences between intraperitoneal colorectal injuries and extraperitoneal rectal injuries.
Duration of colostomy and important factors before undertaking colostomy closure will be discussed – as well as duration of antibiotic use.
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References
Rozycki GS, Newman PG (1999) Surgeon-performed ultrasound for the assessment of abdominal injuries. Adv Surg 33:243–259
Chiu WC, Shanmuganathan K, Mirvis SE et al (2001) Determining the need for laparotomy in penetrating torso trauma: a prospective study using triple-contrast enhanced abdominopelvic computed tomography. J Trauma 51:860–868
Cleary RK, Pomerantz RA, Lampman RM (2006) Colon and rectal injuries. Dis Colon Rectum 49:1203–1222
Carrillo EH, Somberg LB, Ceballos CE et al (1996) Blunt traumatic injuries to the colon and rectum. J Am Coll Surg 183:548–552
Moore EE, Cogbill TH, Malangoni MA et al (1990) Organ injury scaling, II: pancreas, duodenum, small bowel, colon, and rectum. J Trauma 30:1427–1429
Stankovic N, Petrovic M, Drinkovic N et al (1996) Colon and rectal war injuries. J Trauma 40:S183–S188
Cayten CG, Fabian TC, Garcia VC, Ivatury R, Morris J (1998) Management of penetrating colon injuries. J Trauma 44(6):941–956
Demetriades D, Murray JA, Chan L et al (2001) Penetrating colon injuries requiring resection: diversion or primary anastomosis? An AAST prospective multicenter study. J Trauma 50:765–775
Miller BJ, Schache DJ (1996) Colorectal injury: where do we stand with repair? Aust N Z J Surg 66:348–352
Ivatury RR, Gaudino J, Nallathambi MN et al (1993) Definitive treatment of colon injuries: a prospective study. Am Surg 59:43–49
Lustosa SA, Matos D, Atallah AN et al (2001) Stapled versus handsewn methods for colorectal anastomosis surgery. Cochrane Database Syst Rev (3):CD003144
Falcone RE, Wanamaker SR, Santanello SA et al (1992) Colorectal trauma: primary repair or anastomosis with intracolonic bypass vs. ostomy. Dis Colon Rectum 35:957–963
Shapiro MB, Jenkins DH, Schwab CW et al (2000) Damage control: collective review. J Trauma 49:969–978
Velmahos GC, Vassiliu P, Demetriades D et al (2002) Wound management after colon injury: open or closed? A prospective randomized trial. Am Surg 68:795–801
Navsaria PH, Shaw JM, Zellweger R et al (2004) Diagnostic laparoscopy and diverting sigmoid loop colostomy in the management of civilian extraperitoneal rectal gunshot injuries. Br J Surg 91:460–464
Velmahos GC, Gomez H, Falabella A et al (2000) Operative management of civilian rectal gunshot wounds: simpler is better. World J Surg 24:114–118
McGrath V, Fabian TC, Croce MA et al (1998) Rectal trauma: management based on anatomic distinctions. Am Surg 64:1136–1141
Gonzalez RP, Falimirski ME, Holevar MR (1998) The role of presacral drainage in the management of penetrating rectal injuries. J Trauma 45:656–661
Ivatury RR, Licata J, Gunduz Y et al (1991) Management options in penetrating rectal injuries. Am Surg 57:50–55
Maxwell RA, Fabian TC (2003) Current management of colon trauma. World J Surg 27:632–639
Velmahos GC, Degiannis E, Wells M et al (1995) Early closure of colostomies in trauma patients – a prospective randomized trial. Surgery 118:815–820
Atweh NA, Vieux EE, Ivatury R et al (1989) Indications for barium enema preceding colostomy closure in trauma patients. J Trauma 29:1641–1642
Dellinger EP, Wertz MJ, Lennard ES et al (1986) Efficacy of short-course antibiotic prophylaxis after penetrating intestinal injury. A prospective randomized trial. Arch Surg 121:23–30
Fabian TC, Croce MA, Payne LW et al (1992) Duration of antibiotic therapy for penetrating abdominal trauma: a prospective trial. Surgery 112:788–794
Ivatury RR, Zubowski R, Psarras P et al (1988) Intra-abdominal abscess after penetrating abdominal trauma. J Trauma 28:1238–1243
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Anand, R.J., Ivatury, R.R. (2014). Surgical Management of Traumatic Colon and Rectal Injuries. In: Di Saverio, S., Tugnoli, G., Catena, F., Ansaloni, L., Naidoo, N. (eds) Trauma Surgery. Springer, Milano. https://doi.org/10.1007/978-88-470-5459-2_14
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DOI: https://doi.org/10.1007/978-88-470-5459-2_14
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