Current Surgery Reports

, 6:19 | Cite as

Management of Penetrating Injury to the Left Colon

  • Nathaniel McQuayEmail author
Trauma Surgery (J. Diaz, Section Editor)
Part of the following topical collections:
  1. Trauma Surgery


Purpose of Review

Does management and outcomes of penetrating injuries to the left colon differ?

Recent Findings

Management pendulum has swung from non-operative management during the Civil War era, to mandatory exploration and fecal diversion by WWII. Continuing advancements in medical management, anesthesia, and surgical techniques have led to the transition from mandatory fecal diversion to primary repair. Civilian trauma experience further supported this paradigm shift with identification of risk factors better defining the role of primary repair. Patients with non-destructive injuries benefited from primary repair, while in those with destructive injuries, resection, and anastomosis is recommended. Injury location historically has been managed with the bias of left-sided colonic injuries mandating fecal diversion due to concerns for increased complications. Evolving literature contradicts such logic as colonic related outcomes appear similar.


The majority of penetrating colon injuries can be managed safely with primary repair despite anatomic injury location as outcomes are similar.


Penetrating trauma Colon injury Damage control Anastomotic leak Primary repair Fecal diversion 


Compliance with Ethical Guidelines

Conflict of interest

Nathaniel McQuay declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Recently published papers of particular interest have been highlighted as: ∙ Of importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Acute Care Surgery, University Hospital Cleveland Medical CenterCase Western Reserve UniversityClevelandUSA

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