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A proctosigmoidectomy, Hartmann's operation or Hartmann's procedure is the surgical resection of the rectosigmoid colon with closure of the anorectal stump and formation of an end colostomy. It was used to treat colon cancer or inflammation (proctosigmoiditis, proctitis, diverticulitis, volvulus, etc.).
Diverticulitis typically presents with lower quadrant abdominal pain of a sudden onset. [1] Patients commonly have elevated C-reactive protein and a high white blood cell count. [10] In Asia it is usually on the right (ascending colon), while in North America and Europe, the abdominal pain is usually on the left lower side (sigmoid colon).
Computed tomography of the abdomen is not routinely necessary, but may show thickening or inflammation in the distal colon (sigmoid colon) with associated diverticulosis. Treatment may consist of antibiotics, aminosalicylates (mesalamine), or prednisone. In rare cases, surgery with segmental resection may be considered.
Diverticular disease occurs when diverticula become clinically inflamed, a condition known as diverticulitis. [3] Diverticula typically occur in the sigmoid colon, which is commonplace for increased pressure. The left side of the colon is more commonly affected in the United States while the right side is more commonly affected in Asia. [4]
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A bowel resection or enterectomy (enter-+ -ectomy) is a surgical procedure in which a part of an intestine (bowel) is removed, from either the small intestine or large intestine. Often the word enterectomy is reserved for the sense of small bowel resection, in distinction from colectomy , which covers the sense of large bowel resection.
Sigmoidectomy is a resection of the last part of the colon, known as the sigmoid colon, and can include part or all of the rectum (proctosigmoidectomy). Precancerous polyps and sigmoid colon cancer are common indications for sigmoidectomy.
The sigmoid colon is completely surrounded by peritoneum (and thus is not retroperitoneal), which forms a mesentery (sigmoid mesocolon), which diminishes in length from the center toward the ends of the loop, where it disappears, so that the loop is fixed at its junctions with the iliac colon and rectum, but enjoys a considerable range of movement in its central portion.