Are We Resecting Too Much Colon in Perforated Diverticulitis?

Autor:	Naraynsingh V; Clinical Surgical Sciences, The University of the West Indies, St. Augustine, TTO.; Surgery, Medical Associates Hospital, St. Joseph, TTO., Maharaj M; Surgery, Regional Health Authority, Sangre Grande, TTO., Rampersad FS; Radiology, The University of the West Indies, St. Augustine, TTO., Hassranah SC; Surgery, The University of the West Indies, St. Augustine, TTO., Maharajh S; Surgery, Medical Associates Hospital, St. Joseph, TTO.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Sep 02; Vol. 16 (9), pp. e68473. Date of Electronic Publication: 2024 Sep 02 (Print Publication: 2024).
DOI:	10.7759/cureus.68473
Abstrakt:	Initially, the Hartmann's procedure was done to reduce mortality in surgery cases of malignant rectal lesions, and not benign disease. However, the procedure was popularized in the management of perforated diverticular disease (PDD) in the 1970s. Herein, we present a case of a patient who had laparotomy and colostomy for PDD. During the post-operative planning for reversal of the diverting colostomy, a contrast study was done that revealed that most of the sigmoid colon was in fact healthy. In this patient, the colon was severed at the point of the perforation and exteriorized, which allowed time for the resolution of the gut inflammatory changes. Thus, Hartmann's operation would have led to the unnecessary resection of the healthy sigmoid colon and possibly condemned the patient to an irreversible stoma. In severe PDD, where a Hartmann's procedure is considered, one could sever the colon at the site of perforation and bring out a colostomy while tacking the closed, unresected distal end near the ostomy. Further contrast studies of the colon could assist in planning resection and anastomosis. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Naraynsingh et al.)
Databáze:	MEDLINE
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