Colonic trauma: modern civilian management and military surgical doctrine.

Colonic trauma, traditionally the domain of the military surgeon, has become commonplace in many parts of the world, where civilian surgeons have developed considerable experience with this complex type of injury. The author highlights the differences between military and civilian management concluding with an overview of current military research into battlefield colonic trauma. This paper reviews military surgical doctrine and summarizes the evolution in civilian surgical practice since the Second World War. South African management is discussed with reference to the author's travelling fellowship visit in 1993. Colonic trauma has been the subject of a military surgical research project, since 1992, with preliminary studies establishing an anastomotic technique suitable for use in the field. This work is summarized with an outline of the research programme.