Transvesical Colorectal Anastomosis: An Unusual Complication inReversal of HartmannÂ’s Procedure

Abstract

It is described an unusual complication after colorectal surgery for reversal of Hartmann’s procedure. The female patient had been operated on for diverticulitis (Hinchey III) according to Hartmann’s procedure. Six months later she underwent restorative surgery with circular stapler for end-to-end transanal anastomosis. The onset of symptoms such as fever, abdominal pain, fecaluria and pneumaturia had forced the patient to a hospital readmission. Diagnostic examinations had revealed colovesical fistula. The cause of this complication was that staple line of colorectal anastomosis had incorporated the bladder wall to full thickness. It was necessary to reoperation for the resolution of the damage. The resection of fistulised tract, the colorectal reanastomosis and the reconstruction of the bladder were performed.