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  • Title: Management of colonic and rectal injuries.
    Author: Hanna SS, Jirsch DW.
    Journal: Can Med Assoc J; 1979 Jun 09; 120(11):1387-91. PubMed ID: 455185.
    Abstract:
    In managing a colonic or rectal injury the surgeon must decide whether it is acceptable to have feces passing over a suture line or anastomosis. If it is, resection and anastomosis or simple oversewing of the bowel can be done. If it is not, there are four choices: (a) closure of the wound, drainage and proximal diversion; (b) primary closure or resection and anastomosis of the wound with exteriorization; (c) formation of a double-barrelled colostomy; and (d) resection of the injured colon with formation of an end-colostomy and a mucosal fistula or a Hartmann procedure. The surgeon's choice should be dictated by the severity of the injury, the degree of fecal contamination and the general condition of the patient.
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