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Updated: Feb 7, 2026

Endoscopic Vacuum Therapy for the Treatment of Anastomotic Leakage after Total Gastrectomy with Esophagojejunostomy
Published on: August 22, 2025
Recurrent Anastomotic Leak After Hartmann Reversal: Successful Management With Vacuum-Assisted Endoscopic Drainage
Ali Ghanem Al Masad1, Omar Reda Abdelmaksoud1
1Gastroenterology & Hepatology, King Khalid Hospital, Najran, Saudi Arabia.
Abstract:
Anastomotic leakage after Hartmann reversal is a challenging complication with limited management options. We report a 27-year-old woman who developed a recurrent leak after reversal surgery. Instead of repeat laparotomy, she underwent combined endoscopic vacuum-assisted therapy and diverting colostomy. Serial sponge exchanges promoted cavity collapse, infection resolution, and granulation, achieving healing without permanent diversion. This case illustrates the role of endoscopic vacuum-assisted therapy as a minimally invasive salvage option for recurrent colorectal leaks, highlighting its value in preserving bowel continuity and reducing morbidity in complex surgical scenarios.
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