Abstract
Optimal management of colon injuries continues to be an evolving and controversial topic. Despite the dramatic reduction of colon-related mortality from about 60% during World War I to about 40% during World War II to about 10% during the Vietnam War and to lower than 3% in the last few decades, the colon-related morbidity remains high. The abdominal sepsis rate has remained significant at about 20% in a large prospective study in 2001 (Table 26-1).1–6 No other organ injury is associated with a higher septic complication rate than colon injury. In the subgroups of patients with colon injuries with a Penetrating Abdominal Trauma Index (PATI) ≥25 or with multiple blood transfusions, the incidence of intraabdominal sepsis has been reported to be as high as 27%.7 In patients with destructive colon injuries requiring resection, the reported incidence of abdominal complications is about 24%.6 Many studies have attempted to identify risk factors for complications and create an optimal management strategy.
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