The redundant sigmoid was resected with the specimen and the colon divided distally just above the rectosigmoid junction. The patient had been partially incontinent prior to the surgery, and there was no plan to later reconnect the colon. The colon was not so dilated that creation of a colostomy and later colon function would be problematic, and it was not safe to submit the patient to the additional trauma and morbidity of a subtotal colectomy. In addition, management of an iliostomy in a nursing home patient is much more difficult than management of a left sided colostomy. Therefore, segmental resection with a Hartmann's procedure was the procedure of choice.
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