The management of the injured colon and rectum has been one of the more controversial surgical topics over the past century. The accumulated experiences of wartime surgeons caring for battle casualties guided the care of colon and rectal wounds for a number of years until prospective trials could address their optimal management. While often constrained by official doctrine, these surgeons made great contributions to our understanding of these complex patients. From the American Civil War, through the World Wars, Korea, and Vietnam, to modern regional conflicts, the mortality from colorectal battle injuries has fallen from greater than 90% to less than 5% today.
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