Recurrent Anastomotic Leak After Hartmann Reversal: Successful Management With Vacuum-Assisted Endoscopic Drainage and Diversion

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.