system
Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
A 19-year-old man is brought into the emergency department with a gunshot wound that occurred 4 hours before admission. At exploratory laparotomy, an injury is noted in the transverse colon with extensive tissue destruction. There is a large amount of fecal contamination. Management of this injury should include which of the following?
assistant
The correct answer is  The necrotic bowel is resected, the proximal end is constructed as an end colostomy, and the distal end is constructed as a mucous fistula. This is the best procedure because it will avoid an anastomosis in a contaminated abdomen. Any procedure that involves either wound closure or anastomosis in an abdomen with extensive fecal contamination presents a significant risk of leakage and therefore should not be performed. Exteriorization should not be performed unless ischemic bowel is resected.