# Coloarticular Fistula as a Long-Term Sequela of the Hartmann Procedure

## TL;DR

A rare complication called coloarticular fistula occurred in a patient after a Hartmann procedure, requiring complex interdisciplinary treatment.

## Contribution

This case report adds to the limited literature on coloarticular fistula following the Hartmann procedure.

## Key findings

- A 78-year-old patient developed a coloarticular fistula after a Hartmann procedure for perforated diverticulitis.
- The condition was diagnosed using gastrografin enema and CT scans, revealing fistulization between the hip prosthesis, rectal stump, adnexa, and cecum.
- Treatment involved abscess drainage, arthroplasty revision, and exploratory laparotomy.

## Abstract

Coloarticular fistula is a rare complication of the Hartmann procedure, reported in the literature only a few times. Risk factors may include underlying colonic malignancy and other proinflammatory conditions. Herein, we describe the case of a 78-year-old female with a recent history of total hip replacement, misdiagnosed Crohn's disease, and a Hartmann procedure for perforated diverticulitis who developed a psoas abscess. Further investigation, including gastrografin enema and computerized tomography, revealed significant fistulization between her hip prosthesis, rectal stump, adnexa, and cecum. Intervention required extensive interdisciplinary decision-making, and the patient underwent interventional radiology-guided abscess drainage, arthroplasty revision, and exploratory laparotomy.