What is a potential risk associated with Hartmann's pouch?

The risk associated with Hartmann's pouch, particularly divertion colitis due to flora imbalance, arises from the surgical creation of a colostomy when a portion of the colon is resected, and the distal segment is left in the pelvis. This distally excluded segment may no longer be adequately colonized by the normal intestinal flora, leading to an imbalance that can cause inflammation of the mucosa, termed divertion colitis.

In patients with Hartmann's pouch, this inflammatory condition can manifest with symptoms such as rectal bleeding, mucosal ulceration, or increased mucus discharge. The absence of fecal flow to the distal bowel reduces the normal stimulation and conditioning from fecal contents, which further contributes to the flora imbalance and subsequent complications.

Recognizing divertion colitis as a potential risk emphasizes the importance of vigilant monitoring for patients with Hartmann's pouch and the need for appropriate management of their condition.