[Colon reconstruction after the Hartmann procedure. Laparoscopy or laparotomy?].

The Hartmann procedure - primarily - was introduced for the treatment of cancerous diseases of sigmoid colon and rectum. In the last few years it was performed in cases with complicated inflammation of the left colon, colon cancers with bowel obstruction or perforation, or in the case of insufficiency of the anastomoses, or in urgent operations after traumatics bowel injuries, when making the anastomosis is at very high risk. Later on the restoration of the continuity of the GI tract can be done traditionally (by laparotomy) or laparoscopically.

[Gastric wall necrosis owing to its incarceration through a rupture of the diaphragm into the left thoracic cavity].

A 73 year-old female patient was admitted to the 3rd Medical Department of Semmelweis University with a painful haematoma in the left loin and respiratory disorders. Her general condition was getting progressively worse. Chest X-ray demonstrated a left sided hemopneumothorax caused by a fractured rib.