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Colon Trauma, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Trauma that perforates the colon inflames the cavity in which it lies.

  • Peritoneal inflammation from hollow viscus perforation often requires hours to develop.

  • Mesenteric tears from blu...

Diagnosis

Signs and Symptoms

  • Colon trauma is generally associated with other intra-abdominal and extra-abdominal injuries, commonly to the small intestine.

  • Injuries of significant severity may have mini...

Treatment

Pre-Hospital

  • Cautions:

    • Follow standard pre-hospital guidelines for trauma management (ABCs).

    • Do not remove penetrating foreign bodies.

    • Do not attempt to replace eviscerated bowel; cover with moi...

Follow-Up

Disposition

Admission Criteria

  • Colon injuries require admission for surgical repair or monitoring.

  • All penetrating foreign bodies must be removed to prevent sepsis.

  • Patients with abdominal ecchy...

Pearls and Pitfalls

Patients may initially present with paucity of symptoms: 
  • Observation and serial exams are indicated if mechanism suggests significant blunt abdominal trauma.

Additional Reading

  • Cleary  RK, Pomerantz  RA, Lampman  RM. Colon and rectal injuries. Dis Colon Rectum.  2006;49(8):1203–1222.

  • Goldberg  JE, Steele  SR. Rectal foreign bodies. Surg Clin North Am. ...

Codes

ICD9

  • 863.40 Injury to colon, unspecified site, without mention of open wound into cavity

  • 863.42 Injury to transverse colon, without mention of open wound into cavity

  • 863.50 Injury to colon, unspeci...

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