Colonoscopic Results in Patients with Hartmann’s Colostomy

Purpose: Colonoscopy in patients with colostomy after Hartmann’s procedure could be a quite challenging or special situation. This study aimed to analyze the Colonoscopic results in patients with Hartmann’s colostomy. Methods: Total 79 consecutive patients undergoing colonoscopy before reversal of Hartmann’s operation were retrospectively reviewed. The procedure was performed first through the anus for evaluation of distal colonic/rectal stump, and then through the colostomy to the cecum or terminal ileum for proximal colon evaluation. Results: Cecal insertion was possible in 72 patients; the success rate was 91.1%. The causes of failure were poor or inadequate bowel preparation in 4 patients, colostomy stricture, colonic stenosis, and angulation in 1 patient, respectively. Completeness of the bowel preparation was poor in 21 patients and inadequate in 6 patients, showing bad preparation in 33.3%. Mean Cecal insertion time from colostomy was 5.1 minute. The Colonoscopic finding of proximal part to colostomy was nonspecific in 38 patients, polyp(s) detection in 15 patients, and diverticulosis in 15 patients. In the examination of distal stump, mean length was 18.4cm, two patients couldn’t evaluate the full length of distal stump, and 11 patients showed abnormal findings including polyps, diverticular, and inflammation. Conclusion: These results suggest that most patients with colostomy can evaluate the remained colon or rectum without technical difficulty. However bowel preparation is the most important point to complete the evaluation of the colon in patients with colostomy.