# 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.

## Key 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.