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Malgré l'apparition des biothérapies, la chirurgie garde une place importante dans la prise en charge de cette complication Une procédure en 3 étapes est recommandée avec comme premier temps opératoire une colectomie subtotale avec iléostomie terminale. La conduite à tenir vis-à-vis du moignon rectosigmoïdien lors de ce geste est controversée entre la réalisation d'une intervention de Hartmann ou d'une sigmoïdostomie. Le but de ce travail était d'évaluer la validité de l'intervention de Hartmann. Nous avons mené une étude rétrospective portant sur les patients ayant été opérés dans notre service de Chirurgie Digestive du CHU de Nancy-Brabois pour CAG sur RCH au cours des 10 dernières années. Les données recueillies étaient les caractéristiques préopératoires, peropératoires, la morbidité postopératoire et la réalisation d'un rétablissement de la continuité Une comparaison a été effectuée entre les 27 patients (84,4%) qui ont bénéficié d'une intervention de Hartmann et les 5 patients (15,6%) qui ont eu une sigmoïdostomie. La mortalité était nulle et la morbidité totale de 56,3% selon la classification de Clavien-Dindo. Un seul patient (3,7%) du groupe Hartmann a présenté une réouverture du moignon rectosigmoïdien. Le rétablissement de la continuité était réalisé ultérieurement si l'état général du patient le permettait. Une anastomose iléo-anale avec réservoir en J a été réalisée chez 17 (63%) patients du groupe Hartmann Aucune difficulté de dissection du moignon rectosigmoïdien n'a été décrite, CAG) compliquant une rectocolite hémorragique (RCH) est une pathologie sévère ,
ANGLAIS Management of the rectal stump in emergency for severe acute colitis in ulcerative colitis: is Hartmann's pouch a good surgical option? ,
Rectocolite hémorragique ? Colite aigüe grave ? Colectomie subtotale ? Hartmann ? Collection pelvienne ? Réouverture moignon rectosigmoïdien ,