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Education and Imaging. Gastrointestinal: gastric incarceration in parastomal hernia.

Hepato-Bilio-Pancreatic Surgery Unit, General Surgery and Digestive Diseases, University Hospital of Guadalajara, Guadalajara, Spain.
Journal of Gastroenterology and Hepatology (Impact Factor: 3.33). 08/2012; 27(8):1405. DOI: 10.1111/j.1440-1746.2012.07181.x
Source: PubMed
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    ABSTRACT: Abstract Parastomal hernia is the most common late stomal complication. Its appearance is usually asymptomatic. We report a parastomal hernia containing stomach. A 69-year-old patient with end colostomy arrived at the emergency room presenting with abdominal pain associated with vomiting and functioning stoma. She had a distended and painful abdomen without signs of peritoneal irritation and pericolostomic eventration in the left iliac fossa. X-ray visualized gastric fornix dilatation without dilated intestine bowels, and computed tomography showed parastomal incarcerated gastric herniation. Gastrografin (Bayer Australia Limited, New South Wales, Australia) was administered, showing no passage to duodenum. She underwent surgery, with stomal transposition and placement of onlay polypropylene mesh around the new stoma. Parastomal hernias are a frequent late complication of colostomy. Only four gastric parastomal hernia cases are reported in the literature. Three of these four cases required surgery. The placement of prosthetic mesh in the moment of stoma elaboration should be considered as a potential preventive measure.
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