Recurrent Anastomotic Leak After Hartmann Reversal: Successful Management With Vacuum-Assisted Endoscopic Drainage and Diversion

TL;DR

A 27-year-old woman with a recurring anastomotic leak after surgery was successfully treated using a minimally invasive endoscopic vacuum therapy and colostomy.

Contribution

This case demonstrates the successful use of vacuum-assisted endoscopic drainage as a novel, minimally invasive treatment for recurrent anastomotic leaks.

Findings

Vacuum-assisted therapy promoted cavity collapse and infection resolution.

The treatment achieved healing without the need for permanent bowel diversion.

The approach preserved bowel continuity and reduced surgical morbidity.

Abstract

Anastomotic leakage after Hartmann reversal is a challenging complication with limited management options. We report a 27-year-old woman who developed a recurrent leak after reversal surgery. Instead of repeat laparotomy, she underwent combined endoscopic vacuum-assisted therapy and diverting colostomy. Serial sponge exchanges promoted cavity collapse, infection resolution, and granulation, achieving healing without permanent diversion. This case illustrates the role of endoscopic vacuum-assisted therapy as a minimally invasive salvage option for recurrent colorectal leaks, highlighting its value in preserving bowel continuity and reducing morbidity in complex surgical scenarios.

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