title: CT evaluation for 'quiescent' herniation following closure of diverting loop ileostomy.
abstract: OBJECTIVE
  The prevalence of abdominal wall herniation at the site of a previous temporary stoma is uncertain. This cohort study investigated the frequency of radiological abnormalities at the site of a closed diverting loop ileostomy.
  
  
  METHODS
  All patients in whom an ileostomy was raised and later closed during a 5-year period formed the study group. When colorectal cancer surveillance computed tomography (CT) was undertaken the images were scrutinized and graded as to defined anatomical abnormalities.
  
  
  RESULTS
  One hundred and seventy-nine patients had an ileostomy, of which 92 were diverting. Fifty-nine (64%) were closed at various intervals (median time to closure 6 (2-22) months and 43 underwent a surveillance CT at 1-3 (median 2) years. At 1 year an abnormality (atrophy or defect) at the site of closure was seen in 16 (37%) CT scans. These were more frequent with increasing duration of follow-up. One asymptomatic hernia was detected at 2 years but there was no deterioration in the abdominal wall at 3 years when compared with that at 2 years.
  
  
  CONCLUSIONS
  Abnormalities in the abdominal wall at the site of a closed diverting ileostomy are common but true herniation is unusual. The routine use of prophylactic mesh at ileostomy closure may be unnecessary.
authors.affiliation: Departments of Colorectal Surgery, Royal Gwent Hospital, Newport, UK.
authors.forename: Z M
authors.initials: ZM
authors.lastname: Saeed
authors.forename: J
authors.initials: J
authors.lastname: Lloyd-Evans
authors.forename: T D
authors.initials: TD
authors.lastname: Reid
authors.forename: R
authors.initials: R
authors.lastname: Williams
authors.forename: M
authors.initials: M
authors.lastname: Robinson
authors.forename: G L
authors.initials: GL
authors.lastname: Williams
authors.forename: B M
authors.initials: BM
authors.lastname: Stephenson
mesh_terms: D000328:Adult; D000368:Aged; D058070:Asymptomatic Diseases; D015331:Cohort Studies; D005260:Female; D046449:Hernia, Abdominal / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D007081:Ileostomy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000601:surgery*; D014057:Tomography, X-Ray Computed