Penetrating Injuries to the Colon and Rectum

The management of colon and rectal injuries has evolved greatly over the last several decades. Once known to have significant mortality, the implementation of mandatory diversion in the 1940s drastically improved outcomes. Since then, treatment strategies have now shifted towards primary repair as a safe option for the majority of injuries. When wounds are more destructive, resection and primary anastomosis are usually appropriate in most situations. Management of penetrating colon injuries is more complex in the setting of damage control surgery and may require difficult decisions regarding timing of anastomosis. Rectal injuries were also historically known to have significant morbidity until diversion was implemented. Extraperitoneal injuries are still treated in a similar fashion, while intraperitoneal injuries are managed using the same principles as colon injuries. This article will review the management of penetrating colon and rectal injuries with focus on literature that has been published over the last 3 years. © 2015, Springer International Publishing AG.