Spontaneous closure of an ileostomy: A rare occurrence

Abstract

INTRODUCTIONIleostomy is an iatrogenic entero-cutaneous (EC) fistula designed for controlled evacuation of bowel contents. Once ileostomy has served its purpose, it is reverted by surgical procedure. We are reporting an interesting case of spontaneous closure of an ileostomy, obviating the need of surgical intervention. PRESENTATION OF CASEA 26 year old lady presented with perforation peritonitis. Upon exploration, a tubercular perforation of terminal ileum was found. Loop ileostomy was formed and patient was discharged on anti-tubercular treatment (ATT) after an uneventful recovery. During follow up visits, stoma was found to be retracting gradually. Retraction was not associated with any signs of peritonitis. Patient was able to pass stools per rectally. Stoma regressed completely within 8 months followed by epithelialisation of stoma site. Patient was leading an essentially normal life until her last follow up visit. DISCUSSIONConsidering the various factors affecting spontaneous healing of EC fistulas, all the intestinal stomas do have favourable characteristics essential for spontaneous closure. However, this is seldom seen in day to day surgical practice. The factors pertaining to this particular case that led to spontaneous closure of stoma remain poorly understood. CONCLUSIONFurther research is warranted to understand the mechanism behind spontaneous regression of a stoma. Relationship between this event and intestinal tuberculosis or ATT needs to be analysed.