A parastomal hernia causing small-bowel obstruction.
A parastomal hernia is an incisional hernia that occurs at the site of an intestinal stoma on the abdominal wall. We report the case of a 52-year-old woman who had had ulcerative colitis and a total colectomy and ileostomy 9 years before being evaluated for a 2-year history of intermittent small-bowel obstruction thought initially to be due to Crohn's disease. On examination, a clear parastomal hernia was detected and confirmed by a small-bowel series. At surgery the hernia was corrected, and her intermittent episodes of small-bowel obstruction resolved. A parastomal hernia should be considered as a cause of intermittent small-bowel obstruction in anyone who has a stoma. Careful history and physical examination should suffice in establishing a diagnosis.
Markham
D W
DW
Department of Medicine, University of Washington School of Medicine, Seattle, USA.
Ruppert
M
M
Noel
R
R
Surawicz
C M
CM
D003093:Colitis, Ulcerative / Q000601:surgery*; D005260:Female; D006555:Hernia, Ventral / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007081:Ileostomy / Q000009:adverse effects*; D007415:Intestinal Obstruction / Q000209:etiology*; D007421:Intestine, Small; D008875:Middle Aged; D011859:Radiography; D013997:Time Factors