Management of colorectal trauma: a review.
Traumatic colorectal injuries are common during times of military conflict, and major improvements in their care have arisen in such periods. Since World War II, many classification systems for colorectal trauma have been proposed, including (i) Flint Grading System; (ii) Penetrating Abdominal Trauma Index; (iii) Colonic/Rectal Injury Scale; and (iv) destructive/non-destructive colonic injuries. The primary goal of these classifications was to aid surgical management and, more particularly, to determine whether a primary repair or faecal diversion should be performed. Primary repair is now the preferred surgical option. Patients who have been identified as having destructive injuries have been found to have higher anastomotic leak rates after a primary repair. Damage control principles need to be adhered to in surgical decision-making. In this review, we discuss the mechanisms of injury, classifications, clinical presentation and current recommendations for the management of colorectal trauma.
Department of Colorectal Surgery, Concord Institute of Academic Surgery, Concord Clinical School, The University of Sydney, Sydney, New South Wales, Australia.
Ju Yong
http://orcid.org/0000-0002-1600-7632
JY
Cheong
Department of Colorectal Surgery, Concord Institute of Academic Surgery, Concord Clinical School, The University of Sydney, Sydney, New South Wales, Australia.
Anil
A
Keshava
D000465:Algorithms; D003106:Colon / Q000293:injuries* / Q000601:surgery*; D006801:Humans; D009104:Multiple Trauma / Q000175:diagnosis* / Q000601:surgery*; D012007:Rectum / Q000293:injuries* / Q000601:surgery*
colorectal trauma; faecal diversion; primary repair