Colorectal Injury

Definition - Injury to colon or rectum (transverse colon most common)

History - Penetrating trauma (GSW)

Physical Findings - Hypoactive bowels, peritoneal signs, gross rectal blood

Evaluation - Triple contrast CT scan (Gastrografin, barium is irritating), KUB (air lining psoas), f/u sigmoidoscopy

Treatment - operative management (perforation or devascularization), abx (ampicillin/ciprofloxacin/metronidazole)

• ⊖ risk factors (fecal contamination, shock, multiple injuries, delayed intervention) → Primary repair

• ⊕ risk factors → end colostomy w/ fistula or Hartmann pouch w/ proximal colostomy/ileostomy.