title: 3D intrastomal ultrasonography, an instrument for detecting stoma-related fistula.
abstract: BACKGROUND
  The aim of the present study was to evaluate the recently developed 3D intrastomal ultrasonography in diagnosing stoma-associated complaints and suspected complications after parastomal hernia repair such as peristomal fistula and abscesses.
  
  
  METHODS
  3D intrastomal ultrasonography was used to image peristomal tissue in two patients with complaints after parastomal hernia repair performed with IPOM (intraperitoneal onlay mesh). One patient had ulcerative colitis and one Crohn's disease. Both patients were investigated because of pain and in one case also signs of a subcutaneous abscess.
  
  
  RESULTS
  Intrastomal ultrasonography revealed fistulas connected to the intestinal segment leading to the stoma in both cases. Both cases also showed signs of a fistula descending to the abdominal cavity. In one case, a subcutaneous abscess was identified and in the other a small abscess adjacent to the fistula and the edge of the fascia.
  
  
  CONCLUSIONS
  Stoma complaints after surgery for parastomal hernia with implantation of IPOM mesh can be diagnosed using 3D intrastomal ultrasonography. This new 3D technique for imaging intrastomal hernia can be used to complement traditional methods in the detection of stoma-associated abscesses and fistulas with or without foreign material such as mesh.
authors.affiliation: Division of Surgery, Department of Clinical Science, Intervention and Technology, CLINTEC, Karolinska Institutet at the Karolinska University Hospital/Huddinge, Stockholm, Sweden.
authors.forename: U
authors.initials: U
authors.lastname: Gunnarsson
authors.forename: K
authors.initials: K
authors.lastname: Strigård
mesh_terms: D000038:Abscess / Q000000981:diagnostic imaging* / Q000209:etiology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017577:Cutaneous Fistula / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology; D005260:Female; D006547:Hernia / Q000209:etiology; D059685:Herniorrhaphy / Q000009:adverse effects; D006801:Humans; D021621:Imaging, Three-Dimensional; D007412:Intestinal Fistula / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology; D008297:Male; D008875:Middle Aged; D013526:Surgical Mesh; D054047:Surgical Stomas / Q000009:adverse effects*; D014463:Ultrasonography
chemical_list: D000900:Anti-Bacterial Agents