Closure of Hartmann's Colostomy: A Simple Method for Identifying the Rectal Stump

Abstract

Background: Restoration of intestinal continuity after Hartmann’s colostomy can be very difficult especially in patients with short rectal stumps that are retracted and buried deep in the pelvis. Objective: To demonstrate a simple method of overcoming the difficulty in the reversal of Hartmann’s colostomy. Method: A retrospective descriptive study of cases of Hartmann’s colostomy reversal was done. Results: The technique was used in the reversal of 9 Hartmann’s colostomies carried out over a period of 16 years between 1995 and 2010. The patients comprised five males and four females. The diagnoses in the males were four cases of sigmoid volvulus, and one gunshot injury. The diagnoses in the four females included sigmoid volvulus, carcinoma of the colon, stricture from endometriosis and gangrenous sigmoid colon from criminal abortion. The mean time for restoration of intestinal continuity after the primary procedure was 7.8 months. Two patients had postoperative wound infection. There was no mortality. Conclusion: The simple technique was found to be helpful especially in situations where other instruments that facilitate the restorative process are not available

Keywords

• Colostomy
• Harrtmann's procedure
• Hartmann's reversal
• rectal stump