Background: The management of colon trauma seems to have swung from the "diversion dogma" to a more liberal use of primary repair. However, there are still debatable issues, regarding the management of destructive injuries of the left colon.
Methods: A review of the current literature on the management of colon trauma was performed using PubMed, with secondary references obtained from key articles.
Conclusion: There is strong evidence from prospective randomised trials that the vast majority of colonic injuries can be safely managed by primary repair. It seems, however, that there is a limited role for colostomy, particularly in high-risk patients with destructive injuries of the left colon. The final decision should be based on available scientific evidence in combination with personal experience and clinical judgement on the given patient.