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Colon Trauma: Evidence-Based Practices.

Ryo Yamamoto1, Alicia J Logue2, Mark T Muir1

  • 1Division of Trauma and Emergency Surgery, Department of Surgery, The University of Texas Health Science Center at San Antonio, San Antonio, Texas.

Clinics in Colon and Rectal Surgery
|January 31, 2018
PubMed
Summary
This summary is machine-generated.

Colon injuries, both penetrating and blunt, require careful management. Current evidence supports primary anastomosis for most penetrating colon injuries, and algorithms may guide treatment for blunt and damage control surgery cases.

Keywords:
blunt colon injurydamage control surgerydestructive colon injurynondestructive colon injuryostomy

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Area of Science:

  • Trauma Surgery
  • Surgical Gastroenterology
  • Colorectal Surgery

Background:

  • Colon injuries are frequent in penetrating hollow viscus trauma.
  • Optimal management for destructive and blunt colon injuries remains debated.
  • The role of damage control surgery (DCS) in colonic injuries is under investigation.

Purpose of the Study:

  • To review current evidence on managing penetrating and blunt colon injuries.
  • To discuss the application of existing algorithms in blunt colon injury and DCS settings.
  • To provide insights into the optimal surgical strategies for various colon injury types.

Main Methods:

  • Literature review of studies on penetrating, blunt, and DCS-related colon injuries.
  • Analysis of evidence supporting segmental resection with primary anastomosis.
  • Evaluation of algorithms for operative decision-making in colon trauma.

Main Results:

  • Segmental resection with primary anastomosis is supported for most penetrating colon injuries without comorbidities or massive transfusion.
  • Algorithms developed for penetrating colon injuries may be applicable to blunt colon injuries.
  • Damage control surgery for colon injuries may not increase risk if fascial closure is achieved promptly.

Conclusions:

  • Primary anastomosis is a viable option for many penetrating colon injuries.
  • Management algorithms can guide treatment for blunt and DCS-related colon injuries.
  • Further research is needed to refine optimal surgical strategies for complex colonic trauma.