Abstract
The authors discuss the history and evolution of management of traumatic wounds to
the colon and rectum, summarizing early management parallel with the history of armed
conflict followed by the increase in research and management interest by civilian
centers in the post-Vietnam era. They explore the strong opinions of the early thought-leaders
such as DeBakey and Ogilvie, detailing factors that may have impacted their views.
The current literature on optimal management of both colon and rectal trauma is reviewed,
including the contentious debate over which patients may benefit from diversion. Current
organ injury staging and clinical practice guidelines are also reviewed, as well as
lessons learned by the U.S. military in recent conflicts in Iraq and Afghanistan.
Understanding of the evolution of colon and rectal trauma management, as well as the
current literature, will help surgeons in their decision-making and management of
these challenging injuries.
Keywords
colon - rectum - trauma - injury - management - combat - military - diversion
