[Injuries of the small and large intestine]

While laparotomy is always mandatory for penetrating injuries of the intestine, its indication for blunt trauma is still difficult because of diagnostic problems. Late interventions are responsible for a poor prognosis in these patients. While the operative management of small bowel ruptures is mostly unproblematic injury of the large intestine demands more differential treatment. In cases of contaminated abdominal cavity and the necessity of bowel resection a so-called anastomosis stoma should be used if possible. In case of major trauma of the rectosigmoid, a Hartmann procedure may be necessary. Profuse drainage and colostomy are required in cases of trauma of the extraperitoneal part of the rectum.