Laparoscopic Hartmann's Procedure: A Feasible Approach for Stable Patients with Colonic Trauma
Cristina Frattini, MD; Arianna Birindelli, MD; Edoardo Segalini, MD; Alberto Casati, MD; Gregorio G. Tugnoli, MD; Salomone Di Saverio, MD, FACS
Product Details |
Product ID: |
ACS-5657 |
Year Produced: |
2018 |
Length: |
11 min. |
Two cases of traumatic colonic perforation came to our attention: a 72 year-old man, who developed abdominal pain and tenderness after the insertion of a rectal foreign body, and a 77 year-old man with blunt abdominal trauma after a car crash. In both cases, patients were hemodynamically stable, so they underwent a CT scan, which showed the presence of free abdominal air and free fluid, suggestive for bowel perforation. In the first case an explorative laparoscopy revealed a perforation at the rectosigmoid junction caused by the foreign body, while in the second, a laceration involving 270° of the sigmoid colon circumference was discovered. In both cases, a laparoscopic Hartmann's procedure was performed, and patients were discharged in good condition after a week. Laparoscopic treatment of traumatic colonic perforation, with a minimally invasive Hartmann's procedure, is a valid option in hemodinamically stable patients with blunt or penetrating colonic trauma in presence of laparoscopic expertise.