Colonic injuries often present as persistent abdominal pain following abdominal trauma, or abdominal pain following medical manipulation, often accompanied by an elevated temperature, and may present with abdominal muscle tension due to the presence of peritonitis symptoms. Patients with trauma may have signs of combined abdominal skin contusions, etc. Symptoms of retroperitoneal colonic injury are atypical and can easily be missed clinically. Abnormal signs can be detected in such patients by serial observation.