A 70-year-old man presents with complete large bowel obstruction due to a splenic flexure carcinoma. The bowel is viable but edematous. The most appropriate emergency procedure is:

• A Primary resection and anastomosis with on-table lavage
• B Hartmann's procedure ✓
• C Extended right hemicolectomy
• D Loop colostomy alone

Explanation

Hartmann's procedure (resection of the affected segment with end colostomy and closure of the rectal stump) is the safest option for an obstructed left colon with edema, as it avoids the risk of anastomotic leak. Primary anastomosis with lavage is an alternative in selected patients without peritonitis, but Hartmann's is preferred in emergency settings with significant contamination.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.