Trauma, Bowel Obstruction, and Colorectal Emergencies

Colorectal emergencies encompass a wide range of diagnoses, from the uncommon blunt anal sphincter injury to the more common lower gastrointestinal hemorrhage or large bowel obstruction. In this issue of Clinics in Colon and Rectal Surgery, we will critically evaluate eight clinical entities and provide an evidence-based guide to their treatment.

Trauma can affect any organ system within the body; unfortunately, the colon, rectum, and anus are not spared insult. Drs. Marlin Wayne Causey from Fort Lewis, Washington, David E. Rivadeneir, from Smithtown, New York, and Scott R. Steele, also from Fort Lewis, Washington, review the current recommendations for the management of colonic trauma, as well as provide a historic look at how we have arrived at these recommendations. Dr. Rebecca Sawai from Kaiser Permanente in Honolulu, Hawaii, provides an update on the overall care of patients with colonic obstruction.

One disease, which has seen an increase in severity recently and has been reported in the mainstream media, is Clostridium difficile colitis. Dr. Ann Seltman from the University of Minnesota discusses the critical aspects of the disease and outlines “best practice” for the care of patients with C. difficile colitis. Dr. Daniel Herzig from OHSU in Portland, Oregon, tackles the topic of trauma to the anus and rectum. Drs. Kyle Cologne and Glenn Ault discuss the related topic of rectal foreign bodies and their management.

One of the more common reasons for consultation of a colon and rectal surgeon is for a patient with hematochezia. Drs. Tal Raphaeli and Raman Menon from the Swedish Colon and Rectal Clinic in Seattle, Washington, provide a comprehensive guide to the diagnosis and management of the patient with lower gastrointestinal hemorrhage. The patient suffering from colonic ischemia can present with varied symptoms, and Drs. Christopher Washington and Joseph Carmichael from the University of California, Irvine, detail current evaluation and techniques for their care. Finally, to complete this issue of Clinics in Colon and Rectal Surgery, Drs. Dan Gingold and Zuri Murrell from Cedars-Sinai, Los Angeles, California, undertake a specific look at patients with colonic volvulus.

It has been an honor for me to serve as Guest Editor for this issue of Clinics in Colon and Rectal Surgery. I wish to thank all of the authors herein who were so generous with their time and effort to provide the following articles.