SIGMOID MESENTERIC TEAR IN BOWEL (HARTMANS PROCEDURE)

Due to the Sigmoid tear it was necessary to have a HARTMANS procedure resulting in a colostomy. I was told at first that it would be permanent this turned out not to be. Mr. Hemingway at the Leicester royal infirmary agreed to attempt a reversal of the HARTMANS on 02/07/04. The operation was a success and a temporary illiostomy was formed. I was told that the illiostomy would be reversed about 12 weeks after the HARTMANS reversal. This procedure was carried out on 29/09/04. This operation had complications and I suffered a anastamotic leak. This resulted in septicemia and peritonitis and an emergency operation. The laperostomy scar was opened again for the third time and another illiostomy and a mucus fistula formed. a few days after this operation the main wound dehisced and part of my Jejunum had appeared in the middle of the wound fig1.0 fig 1.3 this became prolapsed fig1.1 fig 1.3 photograph taken on 15/10/04. This mucocutaneose apposition has an output of some 6 liters daily. It is managed with a coloplast systems wound manager fig 1.2. I am now due to have an operation to reverse the Mucus Fistula, the Illiostomy along with the Mucocutainius Apposition on 16th August 2005 at the Leicester Royal Infirmary. fig 1.3 photograph taken 12/08/05

I Have now had the reversal operation and it was successfull and i am making a full recovery at home after being in hospital for 2 weeks and one day. the wounds were left open to allow a better chance of healing without complications. fig 1.4 fig 1.5 picture taken 05/09/05 fig1.6 taken on 25/10/05. I did have to have 4 feet of intestines removed and i now have 185cm left so T.PN is not required any longer. B12 injections are being looked at now.

I only had 80cm of small intestines before the fistula fig 1.3. Therefore I was on total parental nutrition for about 11 months. As a result of the last operation i am now off T.P.N And i have now had my Hickman line removed.

fig 1.2

fig 1.3

fig 1.4	fig 1.5