Emergency Central is a collection of disease, drug, and test information including 5-Minute Emergency Medicine Consult, Davis’s Drug, McGraw-Hill Medical’s Diagnosaurus®, Pocket Guide to Diagnostic Tests, and MEDLINE Journals created for emergency medicine professionals. Explore these free sample topics:
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- 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 blunt trauma cause hemorrhage and bowel ischemia.
- Delayed perforation from ischemic or necrotic bowel may occur.
- Peritonitis and sepsis may develop from the extravasated intraluminal flora.
- Ascending and descending colon segments are retroperitoneal.
- The left colon has a higher bacterial load than the right.
- Morbidity and mortality increase if the diagnosis of colon injury is delayed.
- Penetrating abdominal trauma:
- The colon is the 2nd most commonly injured organ in penetrating trauma.
- Gunshot wounds have the highest incidence.
- Transverse colon is most commonly injured.
- Often presents with peritonitis
- Blunt abdominal trauma:
- Colon rarely injured in blunt trauma
- Burst injury occurs from compression of a closed loop of bowel.
- Intestine may be squeezed between a blunt object (lap belt) and vertebral column or bony pelvis.
- Sudden deceleration may produce bowel–mesenteric disruption and consequent devascularization.
- With deceleration, the sigmoid and transverse colon are most vulnerable.
- Transanal injury:
- Iatrogenic endoscopic or barium enema injury
- Foreign bodies used during sexual activities may reach and injure the colon.
- Compressed air under high pressure such as at automobile repair facilities can perforate the colon even if the compressor nozzle is not fully inserted anally.
- Swallowed sharp foreign bodies (toothpick) may penetrate the colon, particularly the cecum, appendix, and sigmoid:
- Most foreign bodies pass without complications.
Unlike adults, children have an equal frequency of blunt and penetrating colon injuries.