[Emergency surgical indications of the colon and rectum--perforation and hemorrhage]

Colorectal perforation per se requires surgical intervention whereas in lower gastrointestinal bleeding localisation of the bleeding point has priority to any therapeutic action. Among the prevailing diagnostic methods coloscopy was found to be clinically most relevant. In profuse bleeding or for the interval detection of angiodysplasia angiography is the means of first choice. Subtotal colectomy has proved advantageous, if resection is necessitated without localisation of the bleeding site. The present operative concept in colonic perforation implies the primary excision of the lesion in diverticular as well as in neoplastic disease.