The Hartmann procedure. Extended indications in severe intra-abdominal infection

Dis Colon Rectum. 1988 Feb;31(2):126-9. doi: 10.1007/BF02562644.

Abstract

During a three-year period, 30 patients had emergency Hartmann procedures for diverticular disease (N = 12), carcinoma (N = 6), trauma (N = 3), and miscellaneous causes (N = 9). Two patients died postoperatively (6.7 percent) and wound infection developed in 60 percent of the patients. Planned relaparotomies for severe intra-abdominal infection were performed in ten patients (an average of 2.5 procedures per patient) with no mortality. In five cases a mucous fistula was converted into a Hartmann pouch; a preference for the Hartmann pouch in patients undergoing repeated explorations is discussed. Colorectal continuity was subsequently restored in 23 patients (76.6 percent).

MeSH terms

  • Abdomen, Acute / surgery*
  • Adult
  • Aged
  • Aged, 80 and over
  • Colon / injuries*
  • Colonic Neoplasms / surgery*
  • Colostomy / adverse effects
  • Colostomy / methods*
  • Colostomy / mortality
  • Diverticulitis, Colonic / surgery*
  • Female
  • Humans
  • Laparotomy
  • Male
  • Middle Aged
  • Reoperation
  • Surgical Wound Infection / epidemiology