Trauma: Colon Trauma

Colon

General

  • Most Common from Penetrating Trauma

AAST Colon Injury Scale

Destructive Bowel Injury

  • Destructive Bowel Injury Definition:
    • > 50% Circumference
    • Devascularized
    • *Grade III-V

Treatment

  • Paracolonic Hematoma:
    • Small & Nonexpanding: Conservative
    • Large or Expanding: Hematoma Evacuation
  • Non-Destructive: Primary Repair
  • Destructive: Resection & Anastomosis
    • Diversion (Ostomy) Indications:
      • Severe Contamination (Not Mild-Moderate)
      • > 4-6 U PRBC Transfusion
      • Shock on Vasopressor Support
      • *Obese Have Many Complications with Stoma – Strongly Consider Anastomosis

Colon Perforation 1

Sigmoid Transection & Jejunum Transection 2

References

  1. Ertugrul G, Coskun M, Sevinc M, Ertugrul F, Toydemir T. Delayed presentation of a sigmoid colon injury following blunt abdominal trauma: a case report. J Med Case Rep. 2012 Aug 20;6:247. (License: CC BY-2.0)
  2. Bansal S, Jain S, Meena LN. Staged management of giant traumatic abdominal wall defect: A rare case report. Burns Trauma. 2013 Dec 18;1(3):144-7. (License: CC BY-4.0)