Is Hartmann’s Pouch an Option in the Management of Acute Severe Ulcerative Colitis?
Abstract
Background: The surgical management of remnant rectosigmoid after subtotal colectomy with end ileostomy for acute severe ulcerative colitis remains controversial with respect to the need to perform sigmoidostomy or Hartmann’s pouch. The aim of this retrospective study was to investigate whether Hartmann’s pouch may be a safe option. Methods: Thirty-eight Hartmann’s pouches were performed between January 2003 and December 2015. We looked at morbidity (with a focus on the occurrence of pelvic sepsis and leakage of the rectal stump) and the rate of restored intestinal continuity. Results: Nineteen patients had surgical complications. Seven had an intra-abdominal collection, only one of which was in the pelvis, and the patient had to be reoperated. Only one patient had a reopening of the rectal stump, which was revealed by rectal bleeding. Twenty-six patients (68.4%) underwent further proctectomy with ileal J-pouch anal anastomosis with no difficulty in localizing or mobilizing the rectal stump and no major surgical complications. Conclusions: Hartmann’s pouch may be considered in patients with acute severe ulcerative colitis, with low rates of morbidity and pelvic sepsis. The restoration of intestinal continuity is possible after this procedure without any special difficulty.
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BibTeX
@article{renaud2026hartmanns,
title = {{Is Hartmann’s Pouch an Option in the Management of Acute Severe Ulcerative Colitis?}},
author = {Myriam Renaud and Ahmet Ayav and Bénédicte Caron and Laurent Peyrin‐biroulet and Adeline Germain},
journal = {Journal of Clinical Medicine},
year = {2026},
month = sep,
doi = {10.3390/jcm11133857},
url = {https://hal.univ-lorraine.fr/hal-04168072v1},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Is Hartmann’s Pouch an Option in the Management of Acute Severe Ulcerative Colitis?
AU - Myriam Renaud
AU - Ahmet Ayav
AU - Bénédicte Caron
AU - Laurent Peyrin‐biroulet
AU - Adeline Germain
PY - 2026
DA - 2026/09/04
JO - Journal of Clinical Medicine
DO - 10.3390/jcm11133857
UR - https://hal.univ-lorraine.fr/hal-04168072v1
AB - Background: The surgical management of remnant rectosigmoid after subtotal colectomy with end ileostomy for acute severe ulcerative colitis remains controversial with respect to the need to perform sigmoidostomy or Hartmann’s pouch. The aim of this retrospective study was to investigate whether Hartmann’s pouch may be a safe option. Methods: Thirty-eight Hartmann’s pouches were performed between January 2003 and December 2015. We looked at morbidity (with a focus on the occurrence of pelvic sepsis and leakage of the rectal stump) and the rate of restored intestinal continuity. Results: Nineteen patients had surgical complications. Seven had an intra-abdominal collection, only one of which was in the pelvis, and the patient had to be reoperated. Only one patient had a reopening of the rectal stump, which was revealed by rectal bleeding. Twenty-six patients (68.4%) underwent further proctectomy with ileal J-pouch anal anastomosis with no difficulty in localizing or mobilizing the rectal stump and no major surgical complications. Conclusions: Hartmann’s pouch may be considered in patients with acute severe ulcerative colitis, with low rates of morbidity and pelvic sepsis. The restoration of intestinal continuity is possible after this procedure without any special difficulty.
SN - 2077-0383
ER -