Abbreviated Laparotomy in Emergency Colorectal Disease from Battlefield Innovations to Modern Practice

Damage control surgery (DCS) has revolutionized the management of critically ill patients with severe colorectal pathology. Initially developed for wartime trauma, DCS principles have been adapted to emergency colorectal surgery, emphasizing rapid contamination control, physiological stabilization, and staged surgical repair. This case series highlights the role of bailout laparotomy in managing life-threatening colorectal emergencies. This series presents seven patients aged 24-76 years, undergoing emergency colorectal surgery for varied conditions such as perforation (self-foreign body insertion and trauma), volvulus, malignant obstruction and inflammatory diseases. Surgical interventions included primary repair, Hartmann's procedure, diversion stomas, and tumor biopsy with decompression. Postoperative management focused on sepsis control and nutritional support, leading to favorable patient outcomes. Emergency colorectal surgery presents significant challenges due to the high risk of sepsis, hemodynamic instability, and complications associated with delayed treatment. DCS, particularly bailout laparotomy, prioritizes patient stabilization over immediate definitive repair, reducing intraoperative risks. This approach has demonstrated success in improving survival rates when minimizing postoperative morbidity care. Despite its advantages, DCS requires careful patient selection to avoid unnecessary staged interventions and prolonged hospitalizations. By allowing physiological stabilization before definitive repair, this approach enhances survival and reduces complications. The adaptation of wartime surgical principles to modern civilian practice underscores the evolving role of DCS in emergency gastrointestinal surgery.