title: Management of colonic and rectal injuries.
abstract: In managing a colonic or rectal injury the surgeon must decide whether it is acceptable to have feces passing over a suture line or anastomosis. If it is, resection and anastomosis or simple oversewing of the bowel can be done. If it is not, there are four choices: (a) closure of the wound, drainage and proximal diversion; (b) primary closure or resection and anastomosis of the wound with exteriorization; (c) formation of a double-barrelled colostomy; and (d) resection of the injured colon with formation of an end-colostomy and a mucosal fistula or a Hartmann procedure. The surgeon's choice should be dictated by the severity of the injury, the degree of fecal contamination and the general condition of the patient.
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D003106:Colon / Q000293:injuries* / Q000601:surgery; D003125:Colostomy; D004322:Drainage; D006801:Humans; D012007:Rectum / Q000293:injuries* / Q000601:surgery; D013530:Surgical Wound Infection / Q000517:prevention & control; D013537:Sutures; D014950:Wounds, Penetrating / Q000601:surgery; D014951:Wounds, Stab / Q000601:surgery
chemical_list: D000900:Anti-Bacterial Agents