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The aim of this study is to assess the safety of Hartmann’s procedure in the management of acute colonic conditions, in terms of postoperative morbidity and mortality associated with the two-stage procedure. Between 1975 and 1994, 80 patients underwent emergency Hartmann’s procedure in our department. Colonic obstruction and/or perforation due to carcinoma was present in 49 cases (61.2%) whereas the procedure was used for palliation in 9 cases (11.3%). Perforation due to diverticulitis was present in 19 cases (23.7%) and obstruction due to radiation enteritis was present in 3 cases (3.8%). Complications developed in 20 patients (morbidity rate: 25%). Eight patients (10%) died in the immediate postoperative period. Colorectal continuity was reestablished in 51 patients. Postoperative morbidity and mortality were 31 and 3.9%, respectively. In conclusion, Hartmann’s procedure is an optimal emergency procedure for complications of carcinoma or diverticulitis of the left colon and including subsequent restoration of bowel continuity has acceptable morbidity and mortality rates.

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