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Clin Colon Rectal Surg 2018; 31(01): 005-010
DOI: 10.1055/s-0037-1602174
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Historical Perspectives on Colorectal Trauma Management

Joshua A. Tyler
1   Department of Surgery, Uniformed Services University of the Health Science, Bethesda, Maryland
2   Division of Colon and Rectal Surgery, Department of General Surgery, Keesler Medical Center, Biloxi, Mississippi
,
David R. Welling
1   Department of Surgery, Uniformed Services University of the Health Science, Bethesda, Maryland
3   Department of Anatomy, Uniformed Services University of the Health Science, Bethesda, Maryland
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Publication History

Publication Date:
19 December 2017 (online)

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Abstract

The authors discuss the history and evolution of management of traumatic wounds to the colon and rectum, summarizing early management parallel with the history of armed conflict followed by the increase in research and management interest by civilian centers in the post-Vietnam era. They explore the strong opinions of the early thought-leaders such as DeBakey and Ogilvie, detailing factors that may have impacted their views. The current literature on optimal management of both colon and rectal trauma is reviewed, including the contentious debate over which patients may benefit from diversion. Current organ injury staging and clinical practice guidelines are also reviewed, as well as lessons learned by the U.S. military in recent conflicts in Iraq and Afghanistan. Understanding of the evolution of colon and rectal trauma management, as well as the current literature, will help surgeons in their decision-making and management of these challenging injuries.

Keywords

colon - rectum - trauma - injury - management - combat - military - diversion