Abstract
Introduction Parastomal herniation commonly occurs following formation of an end-colostomy or ileostomy. Those patients presenting with acute complications of parastomal hernias typically undergo surgical repair. Stomach-containing parastomal hernias are rare.Presentation of case A 92-year-old lady presented to the emergency department with vomiting and abdominal pain. She had undergone a total colectomy with end-ileostomy many years earlier. A computed tomography scan of her abdomen diagnosed gastric outlet obstruction secondary to parastomal stomach herniation. The obstruction resolved with simple nasogastric decompression and the patient did not receive surgery. She was discharged from hospital after two days.Discussion Gastric outlet obstruction secondary to a parastomal hernia is rare. A systematic literature search found 12 previously reported cases. This is the first case managed without invasive procedures.Conclusion For gastric outlet obstruction caused by parastomal herniation, surgeons should consider non-operative management with nasogastric decompression when the patient in question is frail and a poor surgical candidate.
Highlights
Parastomal herniation commonly occurs following formation of an end-colostomy or ileostomy
A meta-analysis comparing surgical repair techniques for parastomal herniation concluded that herniorraphy with mesh was associated with significantly lower recurrence risk compared to primary repair without mesh [4]
We present a case report of a woman who presented to a large metropolitan hospital emergency department with gastric outlet obstruction secondary to a stomach-containing parastomal hernia
Summary
Parastomal herniation commonly occurs following formation of an end-colostomy or ileostomy. Those patients presenting with acute complications of parastomal hernias typically undergo surgical repair. Presentation of case A 92-year-old lady presented to the emergency department with vomiting and abdominal pain. She had undergone a total colectomy with end-ileostomy many years earlier. A computed tomography scan of her abdomen diagnosed gastric outlet obstruction secondary to parastomal stomach herniation. The obstruction resolved with simple nasogastric decompression and the patient did not receive surgery. She was discharged from hospital after two days
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